0000899243-17-027028.txt : 20171120
0000899243-17-027028.hdr.sgml : 20171120
20171120181522
ACCESSION NUMBER: 0000899243-17-027028
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171120
FILED AS OF DATE: 20171120
DATE AS OF CHANGE: 20171120
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NeoMed Management (Jersey) Ltd
CENTRAL INDEX KEY: 0001722665
STATE OF INCORPORATION: Y9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38295
FILM NUMBER: 171214996
BUSINESS ADDRESS:
STREET 1: 13, CASTLE STREET
CITY: ST. HELIER
STATE: Y9
ZIP: JE4 5UT
BUSINESS PHONE: 44 15334 722787
MAIL ADDRESS:
STREET 1: 13, CASTLE STREET
CITY: ST. HELIER
STATE: Y9
ZIP: JE4 5UT
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NeoMed Innovation V Ltd
CENTRAL INDEX KEY: 0001722666
STATE OF INCORPORATION: Y9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38295
FILM NUMBER: 171214995
BUSINESS ADDRESS:
STREET 1: 13, CASTLE STREET
CITY: ST. HELIER
STATE: Y9
ZIP: JE4 5UT
BUSINESS PHONE: 44 1534 722787
MAIL ADDRESS:
STREET 1: 13, CASTLE STREET
CITY: ST. HELIER
STATE: Y9
ZIP: JE4 5UT
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NeoMed Innovation V L.P.
CENTRAL INDEX KEY: 0001721884
STATE OF INCORPORATION: Y9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38295
FILM NUMBER: 171214997
BUSINESS ADDRESS:
STREET 1: 13, CASTLE STREET
CITY: ST. HELIER
STATE: Y9
ZIP: JE4 5UT
BUSINESS PHONE: 44-1534-722787
MAIL ADDRESS:
STREET 1: 13, CASTLE STREET
CITY: ST. HELIER
STATE: Y9
ZIP: JE4 5UT
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Arsanis, Inc.
CENTRAL INDEX KEY: 0001501697
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 273181608
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 890 WINTER STREET, SUITE 230
CITY: WALTHAM
STATE: MA
ZIP: 02451
BUSINESS PHONE: 781-819-5704
MAIL ADDRESS:
STREET 1: 890 WINTER STREET, SUITE 230
CITY: WALTHAM
STATE: MA
ZIP: 02451
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-11-20
1
0001501697
Arsanis, Inc.
ASNS
0001721884
NeoMed Innovation V L.P.
13 CASTLE STREET
ST HELIER
Y9
JE4 5UT
JERSEY
0
0
1
0
0001722665
NeoMed Management (Jersey) Ltd
13 CASTLE STREET
ST HELIER
Y9
JERSEY
0
0
1
0
0001722666
NeoMed Innovation V Ltd
13 CASTLE STREET
ST HELIER
Y9
JERSEY
0
0
1
0
Common Stock
2017-11-20
4
C
0
246682
A
246682
D
Common Stock
2017-11-20
4
C
0
41878
A
288560
D
Common Stock
2017-11-20
4
C
0
279079
A
567639
D
Common Stock
2017-11-20
4
P
0
300000
10.00
A
867639
D
Series B Convertible Preferred Stock
2017-11-20
4
C
0
552487
0.00
D
Common Stock
246682
0
D
Series C Convertible Preferred Stock
2017-11-20
4
C
0
84040
0.00
D
Common Stock
41878
0
D
Series D Convertible Preferred Stock
2017-11-20
4
C
0
952497
0.00
D
Common Stock
279079
0
D
The Series B Convertible Preferred Stock converted into Common Stock on a 0.44650-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series B Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date.
The Series C Convertible Preferred Stock converted into Common Stock on a 0.49832-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series C Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date.
The Series D Convertible Preferred Stock converted into Common Stock on a 0.29300-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series D Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date.
The reported securities are held of record by NeoMed Innovation V L.P. NeoMed Management (Jersey) Limited is the Investment Manager to NeoMed Innovation V L.P. NeoMed Innovation V Limited is the general partner of Neomed Innovation V L.P. By virtue of such relationships, NeoMed Management (Jersey) Limited and NeoMed Innovation V Limited may be deemed to have voting and investment power with respect to the shares held by NeoMed Innovation V L.P. Each of NeoMed Management (Jersey) Limited and NeoMed Innovation V Limited disclaims beneficial ownership of the shares held by NeoMed Innovation V L.P., except to the extent of its or his pecuniary interest therein, if any.
/s/ Mike Gray, as attorney-in-fact on behalf of NeoMed Innovation V L.P.
2017-11-20
/s/ Mike Gray, as attorney-in-fact on behalf of NeoMed Management (Jersey) Limited
2017-11-20
/s/ Mike Gray, as attorney-in-fact on behalf of NeoMed Innovation V Limited
2017-11-20