Filing Details

Accession Number:
0001209191-17-059504
Form Type:
4
Zero Holdings:
No
Publication Time:
2017-11-06 18:46:53
Reporting Period:
2017-11-06
Accepted Time:
2017-11-06 18:46:53
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1624658 Allena Pharmaceuticals Inc. ALNA () DE
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1456654 Fhm Vi, L.l.c. C/o Frazier Healthcare Partners
601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
1456655 Fhm Vi, L.p. C/o Frazier Healthcare Partners
601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
1456656 Frazier Healthcare Vi, L.p. C/o Frazier Healthcare Partners
601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2017-11-06 2,830,373 $0.00 2,830,373 No 4 C Indirect By Frazier Healthcare VI, L.P.
Common Stock Acquisiton 2017-11-06 500,000 $14.00 3,330,373 No 4 P Indirect By Frazier Healthcare VI, L.P.
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect By Frazier Healthcare VI, L.P.
No 4 P Indirect By Frazier Healthcare VI, L.P.
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series A Preferred Stock Disposition 2017-11-06 6,122,448 $0.00 1,466,805 $0.00
Common Stock Series B Preferred Stock Disposition 2017-11-06 4,629,630 $0.00 1,109,159 $0.00
Common Stock Series C Preferred Stock Disposition 2017-11-06 1,061,904 $0.00 254,409 $0.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
Footnotes
  1. The Series A Preferred Stock automatically converted into Common Stock of the Issuer on a 4.174-to-1 basis upon closing of the initial public offering of the Issuer.
  2. The Series B Preferred Stock automatically converted into Common Stock of the Issuer on a 4.174-to-1 basis upon closing of the initial public offering of the Issuer.
  3. The Series C Preferred Stock automatically converted into Common Stock of the Issuer on a 4.174-to-1 basis upon closing of the initial public offering of the Issuer.
  4. The securities are held by Frazier Healthcare VI, L.P. ("Frazier VI"). FHM VI, L.P. ("FHM LP") is the general partner of Frazier VI and FHM VI, L.L.C. ("FHM LLC") is the general partner of FHM LP. Each of FHM LLC and FHM LP disclaims beneficial ownership of all shares held by Frazier VI except to the extent, if any, of such entity's, as applicable, pecuniary interest therein.
  5. Not applicable.