0001209191-19-029668.txt : 20190514 0001209191-19-029668.hdr.sgml : 20190514 20190514163527 ACCESSION NUMBER: 0001209191-19-029668 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190513 FILED AS OF DATE: 20190514 DATE AS OF CHANGE: 20190514 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Douville Philippe CENTRAL INDEX KEY: 0001771205 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38899 FILM NUMBER: 19823274 MAIL ADDRESS: STREET 1: C/O MILESTONE PHARMACEUTICALS, INC. STREET 2: 1111 DR. FREDERIK-PHILIPS BLVD., STE 420 CITY: MONTREAL STATE: A8 ZIP: H4M 2X6 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Milestone Pharmaceuticals Inc. CENTRAL INDEX KEY: 0001408443 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: A8 BUSINESS ADDRESS: STREET 1: 1111 DR. FREDERIK-PHILIPS BLVD STREET 2: SUITE 420 CITY: MONTREAL STATE: A8 ZIP: H4M 2X6 BUSINESS PHONE: (514) 336-0444 MAIL ADDRESS: STREET 1: 1111 DR. FREDERIK-PHILIPS BLVD STREET 2: SUITE 420 CITY: MONTREAL STATE: A8 ZIP: H4M 2X6 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-05-13 0 0001408443 Milestone Pharmaceuticals Inc. MIST 0001771205 Douville Philippe C/O MILESTONE PHARMACEUTICALS INC. 1111 DR. FREDERIK-PHILIPS BLVD, STE 420 MONTR?AL A8 H4M 2X6 QUEBEC, CANADA 0 1 0 0 Chief Scientific Officer Common Shares 2019-05-13 4 C 0 4124 A 43392 D Class A-1 Preferred 2019-05-13 4 C 0 4124 0.00 D Common Shares 4124 0 D Each share of Class A-1 Preferred was convertible at any time, at the option of the holder, into Common Shares, on a one-for-one basis, had no expiration date and converted into Common Shares upon the closing of the Issuer's initial public offering. /s/ Eric Popp, Attorney-in-Fact 2019-05-14