Statement of Changes in Beneficial Ownership (4)
March 11 2020 - 5:55PM
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
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BARBARI SHARON SURREY |
2. Issuer Name and Ticker or Trading Symbol
Menlo Therapeutics Inc.
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MNLO
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
200 CARDINAL WAY, 2ND FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/9/2020 |
(Street)
REDWOOD CITY, CA 94063
(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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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 Options | $4.50 | 3/9/2020 | | A | | 29271 | | (1) | 5/16/2029 | Common Stock | 29271 | (2) | 29271 | D | |
Explanation of Responses: |
(1) | The ordinary shares underlying these options vest over a 12 month period, in equal, quarterly installments, ending May 16, 2020. |
(2) | Received in or in connection with the merger of Foamix Pharmaceuticals Ltd. ("Foamix"), and Giants Merger Subsidiary Ltd., a direct, wholly owned subsidiary of Menlo Therapeutics Inc. ("Menlo"), in exchange for Foamix equity securities, as further described in the Form 4 filed by the Reporting Person on the date hereof in respect of the Reporting Person's interests in Foamix equity securities. The Reporting Person also received certain contingent stock rights which are subject to the terms and conditions of the contingent stock rights agreement, dated as of March 9, 2020, by and between American Stock Transfer & Trust Company, LLC and Menlo, or related contractual interests, either of which may entitle the Reporting Person to certain additional Menlo equity securities or the adjustment of certain Menlo equity securities, all as further described in that Current Report on Form 8-K filed by Menlo with the Securities and Exchange Commission on March 9, 2020. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
BARBARI SHARON SURREY 200 CARDINAL WAY, 2ND FLOOR REDWOOD CITY, CA 94063 | X |
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Signatures
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/s/ Mutya Harsch, attorney-in-fact for Sharon Surrey Barbari | | 3/11/2020 |
**Signature of Reporting Person | Date |
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