Statement of Changes in Beneficial Ownership (4)
April 03 2020 - 6:22PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Kennedy Eugene P. |
2. Issuer Name and Ticker or Trading Symbol
LUMOS PHARMA, INC.
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(LUMO)
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
Chief Medical Officer |
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(Last)
(First)
(Middle)
4200 MARATHON BLVD., SUITE 200 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
4/1/2020 |
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(Street)
AUSTIN, TX 78756
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Common Stock | 4/1/2020 | | A | | 9000 (1) | A | $0 | 10484 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security
(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) | $7.87 | 4/1/2020 | | A | | 45000 | | (2) | 3/31/2030 | Common Stock | 45000.0 | $0 | 45000 | D | |
| Explanation of Responses: |
| (1) | Represents shares issued as restricted stock units ("RSUs") under the Issuer's 2009 Equity Incentive Plan, as amended, (the "Plan") that were received as an award, for no consideration. The RSUs vest in a series of four successive annual installments beginning on April 1, 2021, provided in each case that the Reporting Person's continuous service to the Issuer has not been terminated as defined in or as determined under the Plan. |
| (2) | Grant to the Reporting Person of a stock option under the Plan. The option vests and becomes exercisable in a series of 48 successive equal monthly installments beginning on May 1, 2020, provided that at the relevant vesting dates the Reporting Person's continuous service to the Issuer has not been terminated as defined in or as determined under the Plan. The option expires ten years after the date of grant. |
Remarks:
The Issuer effected a 1-for-9 reverse stock split of its common stock on March 18, 2020. All share and per share exercise price amounts shown in this Form 4 have been adjusted to reflect the reverse stock split. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Kennedy Eugene P.
4200 MARATHON BLVD.
SUITE 200
AUSTIN, TX 78756 |
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| Chief Medical Officer |
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Signatures
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| /s/ Ryan Trytten, attorney-in-fact | | 4/3/2020 |
| **Signature of Reporting Person | Date |
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