0001485003-16-000174.txt : 20160922 0001485003-16-000174.hdr.sgml : 20160922 20160922165404 ACCESSION NUMBER: 0001485003-16-000174 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160920 FILED AS OF DATE: 20160922 DATE AS OF CHANGE: 20160922 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Eleven Biotherapeutics, Inc. CENTRAL INDEX KEY: 0001485003 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 252025616 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 215 FIRST STREET STREET 2: SUITE 400 CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-871-9911 MAIL ADDRESS: STREET 1: 215 FIRST STREET STREET 2: SUITE 400 CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HURLY STEPHEN A CENTRAL INDEX KEY: 0001130637 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36296 FILM NUMBER: 161898052 MAIL ADDRESS: STREET 1: C/O ELEVEN BIOTHERAPEUTICS STREET 2: 215 FIRST ST. #400 CITY: CAMBRIDGE STATE: MA ZIP: 02142 4 1 wf-form4_147457763133880.xml FORM 4 X0306 4 2016-09-20 0 0001485003 Eleven Biotherapeutics, Inc. EBIO 0001130637 HURLY STEPHEN A C/O ELEVEN BIOTHERAPEUTICS, INC. 215 FIRST STREET, SUITE 400 CAMBRIDGE MA 02142 1 1 0 0 President and CEO Common Stock 2016-09-20 4 A 0 398031 A 398031 D Stock Option 3.37 2016-09-20 4 A 0 350000 0 A 2026-09-19 Common Stock 350000.0 350000 D The reporting person acquired 398,031 shares of issuer common stock in exchange for a 9.9175% interest in Viventia Bio Inc. pursuant to the issuer's purchase of all of the outstanding capital stock of Viventia Bio Inc. on September 20, 2016. Of the 398,031 shares issued to the reporting person in the transaction, 39,803 shares are currently being held in escrow and are subject to forfeiture during the 15-month period following the transaction to satisfy claims arising as a result of Viventia Bio Inc.'s or the reporting person's breach of any of its or his representations, warranties or covenants in the share purchase agreement. 25% of the shares subject to such option shall vest on the first anniversary of the date of grant of the option and an additional 6.25% of the shares underlying the option shall vest at the end of each successive three-month period thereafter until the fourth anniversary of the date of grant of the option. /s/ Stephen A. Hurly 2016-09-22