Form 3 Lsp V Management B.v.

Initial statement of beneficial ownership of securities

Published: 2019-04-22 20:33:24
Submitted: 2019-04-22
Period Ending In: 2019-04-12
e618381_3-lsp.html


SEC FORM 3

SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
LSP V Cooperatieve U.A.

(Last) (First) (Middle)
JOHANNES VERMEERPLEIN 9

(Street)
AMSTERDAM P7 1071 DV

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/12/2019
3. Issuer Name and Ticker or Trading Symbol
IMMUNIC, INC. [ IMUX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 2,162,782(1)(2) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
LSP V Cooperatieve U.A.

(Last) (First) (Middle)
JOHANNES VERMEERPLEIN 9

(Street)
AMSTERDAM P7 1071 DV

(City) (State) (Zip)
1. Name and Address of Reporting Person*
LSP V Management B.V.

(Last) (First) (Middle)
JOHANNES VERMEERPLEIN 9

(Street)
AMSTERDAM P7 1071 DV

(City) (State) (Zip)
Explanation of Responses:
1. On April 12, 2019, pursuant to an Exchange Agreement, dated as of January 6, 2019, between the Issuer (then known as Vital Therapies, Inc.), Immunic AG ("Immunic"), and the shareholders of Immunic party thereto (the "Exchange Agreement"), the holders of Immunic ordinary shares exchanged all of their outstanding shares for shares of Issuer common stock, resulting in Immunic becoming a wholly-owned subsidiary of the Issuer (the "Transaction"). Immediately following the Transaction, the Issuer changed its name to "Immunic, Inc." In connection with the Transaction, the Reporting Person received shares of common stock of the Issuer.
2. Represents shares of the Issuer held by LSP V Cooperatieve U.A. ("LSP V"). LSP V Management B.V. is the director and manager of LSP V.
LSP V Management B.V., /s/ Martijn Kliejwegt, Managing Director 04/22/2019
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.
1
e618381_3-lsp.xml
Schema Version:
X0206
Document Type:
3
Period Of Report:
2019-04-12
No Securities Owned:
0

Issuer

Issuer Cik
0001280776
Issuer Name
IMMUNIC, INC.
Issuer Trading Symbol
IMUX

Reporting Owner

Reporting Owner Id

Rpt Owner Cik
0001726006
Rpt Owner Name
LSP V Cooperatieve U.A.

Reporting Owner Address

Rpt Owner Street1
JOHANNES VERMEERPLEIN 9
Rpt Owner City
AMSTERDAM
Rpt Owner State
P7
Rpt Owner Zip Code
1071 DV
Rpt Owner State Description
NETHERLANDS

Reporting Owner Relationship

Is Director
0
Is Officer
0
Is Ten Percent Owner
1
Is Other
0

Reporting Owner Id

Rpt Owner Cik
0001726320
Rpt Owner Name
LSP V Management B.V.

Reporting Owner Address

Rpt Owner Street1
JOHANNES VERMEERPLEIN 9
Rpt Owner City
AMSTERDAM
Rpt Owner State
P7
Rpt Owner Zip Code
1071 DV
Rpt Owner State Description
NETHERLANDS

Reporting Owner Relationship

Is Director
0
Is Officer
0
Is Ten Percent Owner
1
Is Other
0

Non Derivative Holding

Security Title
Common Stock

Shares Owned Following Transaction

Value
2162782

Footnote Id

@attributes Id
F1
@attributes Id
F2
Direct Or Indirect Ownership
D

Footnote

0
On April 12, 2019, pursuant to an Exchange Agreement, dated as of January 6, 2019, between the Issuer (then known as Vital Therapies, Inc.), Immunic AG ("Immunic"), and the shareholders of Immunic party thereto (the "Exchange Agreement"), the holders of Immunic ordinary shares exchanged all of their outstanding shares for shares of Issuer common stock, resulting in Immunic becoming a wholly-owned subsidiary of the Issuer (the "Transaction"). Immediately following the Transaction, the Issuer changed its name to "Immunic, Inc." In connection with the Transaction, the Reporting Person received shares of common stock of the Issuer.
1
Represents shares of the Issuer held by LSP V Cooperatieve U.A. ("LSP V"). LSP V Management B.V. is the director and manager of LSP V.

Owner Signature

Signature Name
LSP V Management B.V., /s/ Martijn Kliejwegt, Managing Director
Signature Date
2019-04-22
e618381_ex99.htm


ENT> EX-99 2 e618381_ex99.htm

 

EXHIBIT A

 

Agreement of Joint Filing

 

The undersigned hereby agree that a single Form 3 (or any amendment thereto) relating to the common stock of the Issuer shall be filed on behalf of each of the undersigned and that this Agreement shall be filed as an exhibit to such Form 3.

 

Date: April 22, 2019

 

  LSP V Cooperatieve U.A.
   
 

By LSP V Management B.V

 

  By:   /s/ Martijn Kliejwegt
  Name:   Martijn Kliejwegt
  Title:  

Managing Director 

       
 

LSP V Management B.V

 

  By:   /s/ Martijn Kliejwegt
  Name:   Martijn Kliejwegt
  Title:   Managing Director
       

 

Additional Files
FileSequenceDescriptionTypeSize
0001193805-19-000404.txt   Complete submission text file   11032
$IMUX

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