0000899243-20-015994.txt : 20200610
0000899243-20-015994.hdr.sgml : 20200610
20200610185037
ACCESSION NUMBER: 0000899243-20-015994
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200610
FILED AS OF DATE: 20200610
DATE AS OF CHANGE: 20200610
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Green Park & Golf Ventures II, LLC
CENTRAL INDEX KEY: 0001782733
STATE OF INCORPORATION: TX
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955769
BUSINESS ADDRESS:
STREET 1: 5910 N. CENTRAL EXPY
STREET 2: SUITE1400
CITY: DALLAS
STATE: TX
ZIP: 75206
BUSINESS PHONE: 2149165750
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPY
STREET 2: SUITE1400
CITY: DALLAS
STATE: TX
ZIP: 75206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GPG LPI Investment, LLC
CENTRAL INDEX KEY: 0001814288
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955770
BUSINESS ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
BUSINESS PHONE: 214-916-5750
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lantern 3-19 Investment, LLC
CENTRAL INDEX KEY: 0001814295
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955771
BUSINESS ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
BUSINESS PHONE: 214-916-5750
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Health Wildcatters Fund II, LLC
CENTRAL INDEX KEY: 0001814292
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955772
BUSINESS ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
BUSINESS PHONE: 214-916-5750
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Health Wildcatters, LLC
CENTRAL INDEX KEY: 0001814291
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955773
BUSINESS ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
BUSINESS PHONE: 214-916-58750
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Green Park & Golf Ventures, LLC
CENTRAL INDEX KEY: 0001598984
STATE OF INCORPORATION: TX
FISCAL YEAR END: 1214
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955774
BUSINESS ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
BUSINESS PHONE: 214-916-5750
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Garcia Gilbert G. II
CENTRAL INDEX KEY: 0001814289
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955775
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Heighten Clay M
CENTRAL INDEX KEY: 0001599114
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955776
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Soderstrom Carl D
CENTRAL INDEX KEY: 0001598985
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39318
FILM NUMBER: 20955777
MAIL ADDRESS:
STREET 1: 5910 N. CENTRAL EXPRESSWAY, SUITE 200
CITY: DALLAS
STATE: TX
ZIP: 75206
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Lantern Pharma Inc.
CENTRAL INDEX KEY: 0001763950
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 463973463
STATE OF INCORPORATION: TX
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1920 MCKINNEY AVENUE
STREET 2: 7TH FLOOR
CITY: DALLAS
STATE: TX
ZIP: 75201
BUSINESS PHONE: 972-277-1136
MAIL ADDRESS:
STREET 1: 1920 MCKINNEY AVENUE
STREET 2: 7TH FLOOR
CITY: DALLAS
STATE: TX
ZIP: 75201
FORMER COMPANY:
FORMER CONFORMED NAME: Lantern Pharma
DATE OF NAME CHANGE: 20190108
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2020-06-10
0
0001763950
Lantern Pharma Inc.
LTRN
0001782733
Green Park & Golf Ventures II, LLC
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
0001814288
GPG LPI Investment, LLC
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
0001814295
Lantern 3-19 Investment, LLC
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
0001814292
Health Wildcatters Fund II, LLC
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
0001814291
Health Wildcatters, LLC
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
0001598984
Green Park & Golf Ventures, LLC
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
0001814289
Garcia Gilbert G. II
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
0001599114
Heighten Clay M
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
0001598985
Soderstrom Carl D
5910 N. CENTRAL EXPY, SUITE 1400
DALLAS
TX
75206
0
0
1
0
Common Stock, par value $0.0001
169756
I
See Footnote
Series A Preferred Stock, par value $0.01
Common Stock
41535
I
See Footnote
Series A Preferred Stock, par value $0.01
Common Stock
292605
I
See Footnote
Series A Preferred Stock, par value $0.01
Common Stock
131697
I
See Footnote
Series A Preferred Stock Warrant (right to buy)
5.45
Common Stock
23733
I
See Footnote
Series A Preferred Stock Warrant (right to buy)
5.45
Common Stock
15804
I
See Footnote
These securities are directly held by Health Wildcatters Fund II, LLC ("HWF II"). Carl D. Soderstrom and Clay M. Heighten, M.D. are the managing members of Green Park & Golf Ventures, LLC ("GPG"), which is the managing member of Health Wildcatters, LLC ("HW"), which is the managing member of HWF II. Therefore, Carl D. Soderstrom, Clay M. Heighten, M.D., GPG, and HW may be deemed to beneficially own these securities.
The Reporting Person acquired these shares of the Issuer's Common Stock, par value $0.0001 (the "Common Stock"), in connection with a series of private transactions conducted prior to the Issuer's initial public offering which commenced on June 10, 2020 (the "Initial Public Offering"). The number of shares of Common Stock set forth in Table I gives effect to the Stock Split (as defined below), which resulted in HWF II's beneficial ownership of Common Stock increasing from 97,561 shares to 169,756 shares.
The number of underlying shares of Common Stock reported in Column 3 of Table II reflects and gives effect to a 1.74-for-1 stock split (the "Stock Split"), to be made effective immediately prior to the closing of the Initial Public Offering.
The Issuer's Series A Preferred Stock, par value $0.01 (the "Series A Preferred Stock"), is convertible at any time, at the holder's election, on a one-for-one basis (subject to adjustments for anti-dilution) for Common Stock, and has no expiration date. In addition, the Series A Preferred Stock will automatically convert into Common Stock upon the closing of an initial public offering meeting certain specified conditions, and it will also convert into Common Stock in the event holders of at least 75% of the Series A Preferred Stock approve a mandatory conversion.
These securities are directly held by GPG LPI Investment, LLC ("GPG LPI"). Carl D. Soderstrom and Clay M. Heighten, M.D. are the managing members of GPG, which is the managing member GPG LPI. Therefore, Carl D. Soderstrom, Clay M. Heighten, M.D., and GPG may be deemed to beneficially own these securities.
These securities are directly held by Lantern 3-19 Investment, LLC ("Lantern 3-19"). Carl D. Soderstrom, Clay M. Heighten, M.D., and Gilbert G. Garcia II are the managing members of Green Park & Golf Ventures II, LLC ("GPG II"), which is the managing member Lantern 3-19. Therefore, Carl D. Soderstrom, Clay M. Heighten, M.D., Gilbert G. Garcia II, and GPG II may be deemed to beneficially own these securities.
The Series A Preferred Stock Warrant is exercisable at any time, at the holder's election, up to and until the Expiration Date (as defined below).
Each Series A Preferred Stock Warrant will expire and no longer be exercisable upon the earliest to occur of (a) 5:00 PM (pacific time) on the fifth anniversary of the date of issuance of such Series A Preferred Stock Warrant and (b) the consummation of a Change of Control (as such term is set forth in the Form of Preferred Stock Warrant filed with the SEC on April 16, 2020, as subsequently amended by that certain Form of Amendment to Preferred Stock Warrant filed with the SEC on May 19, 2020) (collectively, the "Expiration Date").
(9) Signed by Gilbert G. Garcia II in his capacity as Principal of Green Park & Golf Ventures, LLC, the managing member of GPG LPI Investment, LLC.
(10) Signed by Gilbert G. Garcia II in his capacity as Manager of Green Park & Golf Ventures II, LLC, the managing member of Lantern 3-19 Investment, LLC.
(11) Signed by Gilbert G. Garcia II in his capacity as Principal of Green Park & Golf Ventures, LLC, the managing member of Health Wildcatters, LLC, the managing member of Health Wildcatters Fund II, LLC.
(12) Signed by Gilbert G. Garcia II in his capacity as Principal of Green Park & Golf Ventures, LLC, the managing member of Health Wildcatters, LLC.
(13) Signed by Gilbert G. Garcia II in his capacity as Manager of Green Park & Golf Ventures II, LLC.
(14) Signed by Gilbert G. Garcia II in his capacity as Principal of Green Park & Golf Ventures, LLC.
/s/ Gilbert G. Garcia II (8)
2020-06-10
/s/ Gilbert G. Garcia II (9)
2020-06-10
/s/ Gilbert G. Garcia II (10)
2020-06-10
/s/ Gilbert G. Garcia II (11)
2020-06-10
/s/ Gilbert G. Garcia II (12)
2020-06-10
/s/ Gilbert G. Garcia II (13)
2020-06-10
/s/ Gilbert G. Garcia II
2020-06-10
/s/ Clay M. Heighten, M.D.
2020-06-10
/s/ Carl D. Soderstrom
2020-06-10