0001094891-18-000152.txt : 20180711 0001094891-18-000152.hdr.sgml : 20180711 20180711174219 ACCESSION NUMBER: 0001094891-18-000152 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180612 FILED AS OF DATE: 20180711 DATE AS OF CHANGE: 20180711 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: 18949320 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: 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: 18949321 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 2018-06-12 0001624326 PAVmed Inc. PAVM 0001665074 Aklog Lishan ONE GRAND CENTRAL PLACE SUITE 4600 NEW YORK NY 10165 1 1 1 0 Chairman and CEO 0001665114 Pavilion Venture Partners LLC ONE GRAND CENTRAL PLACE SUITE 4600 NEW YORK NY 10165 0 0 1 0 Common Stock 588413 D Common Stock 2018-06-12 4 X 0 1018 A 2303 I By daughter Common Stock 2018-06-12 4 X 0 980 A 2280 I By son Common Stock 4456570 I By Pavilion Venture Partners LLC Common Stock 20000 I By HCFP/AG LLC Series Z Warrants 1.60 2018-04-20 5 G 0 12450 0 D 2018-04-05 2024-04-30 Common Stock 12450 363313 D Subscription Rights (Right to Buy) 1.15 2018-06-12 4 X 0 1018 0 D 2018-05-23 2018-06-12 Units (1 share of Common Stock and 1 Series Z Warrant) 1018 0 I By daughter Series Z Warrants 1.60 2018-06-12 4 X 0 1018 A 2018-04-05 2024-04-30 Common Stock 1018 1018 I By daughter Subscription Rights (Right to Buy) 1.15 2018-06-12 4 X 0 980 0 D 2018-05-23 2018-06-12 Units (1 share of Common Stock and 1 Series Z Warrant) 980 0 I By son Series Z Warrants 1.60 2018-06-12 4 X 0 980 A 2018-04-05 2024-04-30 Common Stock 980 980 I By son Series Z Warrants 1.60 2018-06-26 4 J 0 968019 A 2018-04-05 2024-04-30 Common Stock 2078285 2078285 I By Pavilion Venture Partners LLC Series Z Warrants 1.60 2018-04-05 2024-04-30 Common Stock 10000 10000 I By HCFP/AG LLC The reporting person purchased units from the issuer in the issuer's equity rights offering, each unit consisting of one share of the issuer's common stock and one Series Z Warrant, at a price of $1.15 per unit. Dr. Aklog is a member and sole manager of Pavilion Venture Partners LLC, and has sole voting and dispositive power over the securities held by this entity. Dr. Aklog disclaims beneficial ownership of securities 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 securities held by this entity. Dr. Aklog disclaims beneficial ownership of securities held by this entity, except to the extent of his pecuniary interest therein. Reflects 350,538 Series Z Warrants that previously were held indirectly by Dr. Aklog through HCFP/Capital Partners III LLC, and became held directly by Dr. Aklog on June 26, 2018. The Series Z Warrants were contributed to such entity by its members for no consideration. The contributed Series Z Warrants include 322,673 Series Z Warrants that were previously held indirectly by Dr. Aklog through HCFP/Capital Partners III LLC and became held directly by Dr. Aklog on June 26, 2016. /s/ Dr. Lishan Aklog 2018-07-11 /s/ Dr. Lishan Aklog, as manager of Pavilion Venture Partners LLC 2018-07-11