|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (Right to Buy) | $ 1.46 | (6) | 09/24/2019 | Common Stock | 130,000 | 130,000 | D | ||||||||
Stock Option (Right to Buy) | $ 0.37 | 07/26/2010 | A | 80,000 | 07/26/2011 | 07/26/2020 | Common Stock | 80,000 | $ 0 | 80,000 | D | ||||
Warrant (Right to Buy) | $ 2.71 | 09/11/2007 | 09/11/2012 | Common Stock | 4,210 | 4,210 | I | Leumi Overseas Trust Corp. Ltd. as TTEE of the BTL Trust (1) | |||||||
Warrant (Right to Buy) | $ 1.25 | 07/07/2009 | 07/07/2014 | Common Stock | 16,200 | 16,200 | I | Belldegrun Family Trust (2) | |||||||
Warrant (Right to Buy) | $ 1.71 | 07/07/2009 | 07/07/2014 | Common Stock | 16,200 | 16,200 | I | Belldegrun Family Trust (2) | |||||||
Warrant (Right to Buy) | $ 2.28 | 07/07/2009 | 07/07/2014 | Common Stock | 32,400 | 32,400 | I | Belldegrun Family Trust (2) | |||||||
Warrant (Right to Buy) | $ 1.25 | 07/07/2009 | 07/07/2014 | Common Stock | 60,800 | 60,800 | I | Arie S. Belldegrun M.D. Inc. Profit Sharing Plan (3) | |||||||
Warrant (Right to Buy) | $ 1.71 | 07/07/2009 | 07/07/2014 | Common Stock | 60,800 | 60,800 | I | Arie S. Belldegrun M.D. Inc. Profit Sharing Plan (3) | |||||||
Warrant (Right to Buy) | $ 2.28 | 07/07/2009 | 07/07/2014 | Common Stock | 121,600 | 121,600 | I | Arie S. Belldegrun M.D. Inc. Profit Sharing Plan (3) | |||||||
Warrant (Right to Buy) | $ 1.25 | 07/07/2009 | 07/07/2014 | Common Stock | 73,000 | 73,000 | I | Leumi Overseas Trust Corp. Ltd. as TTEE of the Tampere Trust (4) | |||||||
Warrant (Right to Buy) | $ 1.71 | 07/07/2009 | 07/07/2014 | Common Stock | 73,000 | 73,000 | I | Leumi Overseas Trust Corp. Ltd. as TTEE of the Tampere Trust (4) | |||||||
Warrant (Right to Buy) | $ 2.28 | 07/07/2009 | 07/07/2014 | Common Stock | 146,000 | 146,000 | I | Leumi Overseas Trust Corp. Ltd. as TTEE of the Tampere Trust (4) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Belldegrun Arie C/O NILE THERAPEUTICS, INC. 4 WEST 4TH AVENUE, SUITE 400 SAN MATEO, CA 94402 |
X |
/s/ Daron Evans as Attorney-in-Fact for Arie S. Belldegrun pursuant to Power of Attorney previously filed. | 07/27/2010 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Although the Reporting Person is not a trustee of the BTL Trust, the Reporting Person is a beneficiary of the BTL Trust, and as such may be deemed to be the beneficial owner of the shares and the warrants owned by the BTL Trust. The Reporting Person disclaims beneficial ownership of the shares and warrants except to the extent of his pecuniary interest therein. |
(2) | The Reporting Person is the Trustee of the family trust that owns the shares and the warrants. The Reporting Person disclaims beneficial ownership of these shares and warrants except to the extent of his pecuniary interest therein. |
(3) | The Reporting Person is the Trustee of the profit sharing plan that owns the shares and the warrants. |
(4) | Although the Reporting Person is not a trustee of the Tampere Trust, the Reporting Person is a beneficiary of the Tampere Trust, and as such may be deemed to be the beneficial owner of the shares and the warrants owned by the Tampere Trust. The Reporting Person disclaims beneficial ownership of the shares and warrants except to the extent of his pecuniary interest therein. |
(5) | The Reporting Person is the co-owner of the limited liability company that owns the shares. |
(6) | The shares subject to the option vest in three equal installments on September 24, 2011, September 24, 2012, and September 24, 2013. |