Statement of Changes in Beneficial Ownership (4)
January 19 2021 - 6:17PM
Edgar (US Regulatory)
FORM 4
[X]
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
*
Green Park & Golf Ventures II, LLC |
2. Issuer Name and Ticker or Trading Symbol
Lantern Pharma Inc.
[
LTRN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner _____ Officer (give title below) __X__ Other (specify below) Fmr 10% Owner (see "Remarks") |
(Last)
(First)
(Middle)
5910 N. CENTRAL EXPY, SUITE 1400 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/14/2021 |
(Street)
DALLAS, TX 75206
(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)
___ Form filed by One Reporting Person
_
X
_ 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 |
Explanation of Responses: |
Remarks: The securities which are the subject of this Form 4 are beneficially owned by Green Park & Golf Ventures, LLC ("GPG"), but directly held (in part) by Health Wildcatters Fund II, LLC ("HWF II"), GPG LPI Investment, LLC ("GPG LPI"), or Lantern 3-19 Investment, LLC ("Lantern 3-19"). Carl D. Soderstrom ("Soderstrom") and Clay M. Heighten, M.D. ("Heighten") are the managing members of GPG, which is the managing member of Health Wildcatters, LLC ("HW"), which is the managing member of HWF II. Therefore, Soderstrom, Heighten, GPG, and HW may be deemed to beneficially own the securities covered by this Form 4 which are held by HWF II. Soderstrom and Heighten are the managing members of GPG, which is the managing member GPG LPI. Therefore, Soderstrom, Heighten, and GPG may be deemed to beneficially own the securities covered by this Form 4 which are held by GPG LPI. Soderstrom, Heighten, and Gilbert G. Garcia II ("Garcia") are the managing members of Green Park & Golf Ventures II, LLC ("GPG II"), which is the managing member of Lantern 3-19. Therefore, Soderstrom, Heighten, Garcia, and GPG II may be deemed to beneficially own the securities covered by this Form 4 which are held by Lantern 3-19. GPG, GPG II, GPG LPI, Lantern 3-19, HWF II, HW, Soderstrom, Heighten, and Garcia are collectively referred to herein as the "Reporting Persons".
As a result of the Issuer's public offering, which priced on January 14, 2021 (the "Public Offering Date") and is expected to close on January 20, 2021 (the "Public Offering"), of additional shares of Common Stock, par value $0.0001 (the "Common Stock"), to persons other than the Reporting Persons, each of the Reporting Persons ceased to be the beneficial owner of more than 10% of the Common Stock as of the Public Offering Date. Accordingly, this filing constitutes a Form 4 exit filing for the Reporting Persons, as the Reporting Persons are no longer subject to Section 16 of the Securities Exchange Act of 1934, as amended. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Green Park & Golf Ventures II, LLC 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
Green Park & Golf Ventures, LLC 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
GPG LPI Investment, LLC 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
Lantern 3-19 Investment, LLC 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
Health Wildcatters Fund II, LLC 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
Health Wildcatters, LLC 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
Soderstrom Carl D 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
Heighten Clay M 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
Garcia Gilbert G. II 5910 N. CENTRAL EXPY, SUITE 1400 DALLAS, TX 75206 |
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| Fmr 10% Owner (see "Remarks") |
Signatures
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/s/ Gilbert G. Garcia II (1) | | 1/19/2021 |
**Signature of Reporting Person | Date |
/s/ Gilbert G. Garcia II (2) | | 1/19/2021 |
**Signature of Reporting Person | Date |
/s/ Gilbert G. Garcia II (3) | | 1/19/2021 |
**Signature of Reporting Person | Date |
/s/ Gilbert G. Garcia II (4) | | 1/19/2021 |
**Signature of Reporting Person | Date |
/s/ Gilbert G. Garcia II (5) | | 1/19/2021 |
**Signature of Reporting Person | Date |
/s/ Gilbert G. Garcia II (6) | | 1/19/2021 |
**Signature of Reporting Person | Date |
/s/ Gilbert G. Garcia II | | 1/19/2021 |
**Signature of Reporting Person | Date |
/s/ Clay M. Heighten M.D. | | 1/19/2021 |
**Signature of Reporting Person | Date |
/s/ Carl D. Soderstrom | | 1/19/2021 |
**Signature of Reporting Person | Date |
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