0001104659-16-139254.txt : 20160812
0001104659-16-139254.hdr.sgml : 20160812
20160812124723
ACCESSION NUMBER: 0001104659-16-139254
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160810
FILED AS OF DATE: 20160812
DATE AS OF CHANGE: 20160812
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Gemphire Therapeutics Inc.
CENTRAL INDEX KEY: 0001638287
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 472389984
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 43334 7 MILE ROAD
STREET 2: SUITE 1000
CITY: NORTHVILLE
STATE: MI
ZIP: 48167
BUSINESS PHONE: 248-980-6538
MAIL ADDRESS:
STREET 1: 43334 7 MILE ROAD
STREET 2: SUITE 1000
CITY: NORTHVILLE
STATE: MI
ZIP: 48167
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bisgaier Charles PhD
CENTRAL INDEX KEY: 0001381030
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37809
FILM NUMBER: 161827311
MAIL ADDRESS:
STREET 1: 3985 RESEARCH PARK DRIVE
CITY: ANN ARBOR
STATE: MI
ZIP: 48108
4
1
a4.xml
4
X0306
4
2016-08-10
0
0001638287
Gemphire Therapeutics Inc.
GEMP
0001381030
Bisgaier Charles PhD
43334 SEVEN MILE ROAD
SUITE 1000
NORTHVILLE
MI
48167
1
1
1
0
Chair & Chief Scientific Off.
Common Stock
2016-08-10
4
C
0
59561
A
59561
I
Held by The Charles L. Bisgaier Trust
Common Stock
2016-08-10
4
J
0
6515
6.7059
A
66076
I
Held by The Charles L. Bisgaier Trust
Common Stock
2016-08-10
4
C
0
16144
6.7059
A
82220
I
Held by The Charles L. Bisgaier Trust
Common Stock
2016-08-10
4
C
0
19228
6.7059
A
19228
I
Held by Bisgaier Family, LLC
Common Stock
2016-08-10
4
P
0
51750
10.00
A
1244440
D
Series A Convertible Preferred Stock
2016-08-10
4
C
0
59561
0
D
Common Stock
59561
0
I
Held by The Charles L. Bisgaier Trust
8% Convertible Subordinated Promissory Notes
6.7059
2016-08-10
4
C
0
100000
0
D
Common Stock
16144
0
I
Held by The Charles L. Bisgaier Trust
8% Convertible Subordinated Promissory Notes
6.7059
2016-08-10
4
C
0
125000
0
D
Common Stock
19228
0
I
Held by Bisgaier Family, LLC
The Series A Convertible Preferred Stock converted into shares of common stock, par value $0.001 per share (the "Common Stock"), of Gemphire Therapeutics Inc. (the "Company") on a one-for-one basis immediately prior to the closing of the Company's initial public offering and had no expiration date.
These shares are indirectly owned by the reporting person as trustee of The Charles L. Bisgaier Trust.
Represents shares of Common Stock issued for payment of accrued dividends on the Series A Convertible Preferred Stock.
The notes were issued in the original principal amount of $100,000. The outstanding principal and $8,263 of accrued interest on the notes automatically converted into shares of Common Stock immediately prior to the closing of the Company's initial public offering.
The notes were issued in the original principal amount of $125,000. The outstanding principal and $3,945 of accrued interest on the notes automatically converted into shares of Common Stock immediately prior to the closing of the Company's initial public offering.
/s/ Stephanie Swan, by Power of Attorney
2016-08-12