0001094891-18-000046.txt : 20180216 0001094891-18-000046.hdr.sgml : 20180216 20180216162538 ACCESSION NUMBER: 0001094891-18-000046 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180214 FILED AS OF DATE: 20180216 DATE AS OF CHANGE: 20180216 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Aklog Lishan CENTRAL INDEX KEY: 0001665074 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37685 FILM NUMBER: 18621528 MAIL ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10171 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HCFP/Capital Partners III LLC CENTRAL INDEX KEY: 0001665111 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37685 FILM NUMBER: 18621526 BUSINESS ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 BUSINESS PHONE: 2124011951 MAIL ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pavilion Venture Partners LLC CENTRAL INDEX KEY: 0001665114 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37685 FILM NUMBER: 18621525 BUSINESS ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 BUSINESS PHONE: 2124011951 MAIL ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PAVmed Inc. CENTRAL INDEX KEY: 0001624326 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 471214177 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: ONE GRAND CENTRAL PLACE STREET 2: SUITE 4600 CITY: NEW YORK STATE: NY ZIP: 10165 BUSINESS PHONE: 212-949-4319 MAIL ADDRESS: STREET 1: ONE GRAND CENTRAL PLACE STREET 2: SUITE 4600 CITY: NEW YORK STATE: NY ZIP: 10165 FORMER COMPANY: FORMER CONFORMED NAME: PAXmed Inc. DATE OF NAME CHANGE: 20141105 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2018-02-14 0001624326 PAVmed Inc. PAVM 0001665074 Aklog Lishan ONE GRAND CENTRAL PLACE SUITE 4600 NEW YORK NY 10165 1 1 1 0 Chairman and CEO 0001665111 HCFP/Capital Partners III LLC ONE GRAND CENTRAL PLACE SUITE 4600 NEW YORK NY 10165 0 0 1 0 0001665114 Pavilion Venture Partners LLC ONE GRAND CENTRAL PLACE SUITE 4600 NEW YORK NY 10165 0 0 1 0 Common Stock 2018-02-02 5 G 0 34153 0 D 588413 D Common Stock 1285 I By daughter Common Stock 1300 I By son Common Stock 4456570 I By Pavilion Venture Partners LLC Common Stock 20000 I By HCFP/AG LLC Employee Stock Option (Right to Buy) 2.01 2018-02-14 4 A 0 195108 0 A 2028-02-14 Common Stock 195108 195108 D The reporting person transferred these shares of common stock by bona fide gift to a third party. Dr. Aklog is a member and sole manager of Pavilion Venture Partners LLC, and has sole voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his proportionate pecuniary interest therein. Dr. Aklog is a co-manager of HCFP/AG LLC, and shares joint voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his pecuniary interest therein. The option vests in 12 equal quarterly installments commencing on March 31, 2018. The reporting person no longer has a reportable beneficial interest in the following securities, which were included in the reporting person's prior ownership reports: (i) 125,000 shares of common stock and 125,000 warrants distributed by HCFP/Capital Partners IIIB LLC to its members on a pro rata basis (none of which were distributed to the reporting person); and (ii) 87,020 shares of common stock and 387,020 warrants held by HCFP Inc., over which the reporting person ceased to have investment control. /s/ Dr. Lishan Aklog 2018-02-16 /s/ Dr. Lishan Aklog, as manager of HCFP/Capital Partners III LLC 2018-02-16 /s/ Dr. Lishan Aklog, as manager of Pavilion Venture Partners LLC 2018-02-16