0001104659-24-048343.txt : 20240417 0001104659-24-048343.hdr.sgml : 20240417 20240417163158 ACCESSION NUMBER: 0001104659-24-048343 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240405 FILED AS OF DATE: 20240417 DATE AS OF CHANGE: 20240417 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lizak Carol R. CENTRAL INDEX KEY: 0001785794 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36714 FILM NUMBER: 24851538 MAIL ADDRESS: STREET 1: 201 MISSION STREET, SUITE 2375 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jaguar Health, Inc. CENTRAL INDEX KEY: 0001585608 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 200 PINE STREET SUITE 400 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 BUSINESS PHONE: 415-371-8300 MAIL ADDRESS: STREET 1: 200 PINE STREET SUITE 400 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 FORMER COMPANY: FORMER CONFORMED NAME: Jaguar Animal Health, Inc. DATE OF NAME CHANGE: 20130830 4 1 tm2411853-1_4seq1.xml OWNERSHIP DOCUMENT X0508 4 2024-04-05 0 0001585608 Jaguar Health, Inc. JAGX 0001785794 Lizak Carol R. C/O JAGUAR HEALTH, INC. 200 PINE STREET, SUITE 400 SAN FRANCISCO CA 94104 0 1 0 0 Chief Financial Officer 0 Common Stock 2024-04-05 4 M 0 60 A 611 D Common Stock 106 I See footnote Restricted stock units 2024-04-05 4 A 0 60 0 D Common Stock 60 0 D Restricted stock units convert into common stock on a one-for-one basis. On January 23, 2023, the issuer effected a 75-for-1 reverse stock split of the issued and outstanding shares of its voting common stock (the "January 2023 Reverse Stock Split). Upon effectiveness of the January 2023 Reverse Stock Split, every 75 shares of voting common stock was automatically converted into one share of voting common stock. On September 8, 2021, the issuer effected a 3-for-1 reverse stock split of the issued and outstanding shares of its voting common stock (the "September 2021 Reverse Stock Split"). Upon effectiveness of the September 2021 Reverse Stock Split, every 3 shares of voting common stock was automatically converted into one share of voting common stock. The restricted stock units were previously reported as covering 40,625 shares, but were adjusted to reflect the September 2021 Reverse Stock Split and January 2023 Reverse Stock Split. Such restricted stock units were granted on April 5, 2021 and vest in three equal annual installments beginning on April 5, 2022, the first anniversary of the grant date. Securities held directly by the Peter & Carol Lizak Revocable Trust. Ms. Lizak, by virtue of her position as a co-trustee and beneficiary of such trust and her sharing of voting and investment control over the securities held by the trust with her spouse, may be deemed to beneficially own the securities held by the Peter & Carol Lizak Trust for purposes of Section 16. /s/ Carol R. Lizak 2024-04-17