0001209191-19-029399.txt : 20190513
0001209191-19-029399.hdr.sgml : 20190513
20190513171324
ACCESSION NUMBER: 0001209191-19-029399
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190509
FILED AS OF DATE: 20190513
DATE AS OF CHANGE: 20190513
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Makhzoumi Mohamad
CENTRAL INDEX KEY: 0001630226
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38886
FILM NUMBER: 19819344
MAIL ADDRESS:
STREET 1: 2855 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Trevi Therapeutics, Inc.
CENTRAL INDEX KEY: 0001563880
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 450834299
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 195 CHURCH STREET
STREET 2: 14TH FLOOR
CITY: NEW HAVEN
STATE: CT
ZIP: 06510
BUSINESS PHONE: 203-304-2499
MAIL ADDRESS:
STREET 1: 195 CHURCH STREET
STREET 2: 14TH FLOOR
CITY: NEW HAVEN
STATE: CT
ZIP: 06510
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-05-09
0
0001563880
Trevi Therapeutics, Inc.
TRVI
0001630226
Makhzoumi Mohamad
2855 SAND HILL ROAD
MENLO PARK
CA
94025
0
0
1
0
Common Stock
2019-05-09
4
C
0
1938562
A
1938562
I
See Note 2
Common Stock
2019-05-09
4
P
0
1000000
10.00
A
2938562
I
See Note 2
Common Stock
2019-05-09
4
P
0
1500000
10.00
A
4438562
I
See Note 2
Series C Preferred Stock
2019-05-09
4
C
0
17099315
0.00
D
Common Stock
1938562
0
I
See Note 2
On May 9, 2019, the Series C Preferred Stock, and the dividends that had accrued thereon to date, converted into Common Stock on a 9.5-for-one basis without payment of further consideration automatically upon the closing of the Issuer's initial public offering. The shares had no expiration date.
The Reporting Person is a manager of NEA 16 GP, LLC, ("NEA 16 GP") which is the sole general partner of NEA Partners 16, L.P. ("NEA Partners 16"). NEA Partners 16 is the sole general partner of New Enterprise Associates 16, L.P. ("NEA 16"), which is the direct beneficial owner of the shares. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the shares held by NEA 16 in which the Reporting Person has no pecuniary interest.
Acquired from the Issuer pursuant to a Securities Purchase Agreement dated May 6, 2019 with a closing date of May 9, 2019.
/s/ Sasha Keough, attorney-in-fact
2019-05-13