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Filing Details

Accession Number:
0000899243-19-013261
Form Type:
4
Zero Holdings:
No
Publication Time:
2019-05-13 17:03:50
Reporting Period:
2019-05-09
Accepted Time:
2019-05-13 17:03:50
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1563880 Trevi Therapeutics Inc. TRVI Pharmaceutical Preparations (2834) 450834299
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1641348 Omega Fund V Gp Manager, Ltd. 888 Boylston Street, Suite 1111
Boston MA 02199
No No Yes No
1641354 Omega Fund V, L.p. 888 Boylston Street, Suite 1111
Boston MA 02199
No No Yes No
1641355 Omega Fund V Gp, L.p. 888 Boylston Street, Suite 1111
Boston MA 02199
No No Yes No
1758535 Guyer Anna Mitsak 888 Boylston Street, Suite 1111
Boston MA 02199
Yes No No 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 2019-05-09 582,408 $0.00 582,408 No 4 C Direct
Common Stock Acquisiton 2019-05-09 481,000 $10.00 1,063,408 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Direct
No 4 P Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series C Preferred Stock Disposition 2019-05-09 5,136,986 $0.00 582,408 $0.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Direct
Footnotes
  1. On May 9, 2019, the Series C Preferred Stock, and the dividends that had accrued thereon to date, converted into Common Stock on a 9.5-for-one basis without payment of further consideration automatically upon the closing of the Issuer's initial public offering. The shares had no expiration date.
  2. The reported securities are held directly by Omega Fund V, L.P. ("Omega V"). The reported securities may be deemed to be beneficially owned by each of Omega Fund V GP, L.P. ("Omega V GP"), as the general partner of Omega V, and Omega Fund V GP Manager, Ltd. ("Omega V GP Manager"), as the general partner of Omega V GP. Otello Stampacchia, Richard Lim, Anne-Mari Paster and Claudio Nessi (the "Omega Directors") are all the shareholders and directors of Omega V GP Manager and have shared voting and investment power over the shares held by Omega V. Annie Mitsak, a member of the Issuer's board of directors, has no voting or investment control over any of the shares held by Omega V. Each of Omega V GP, Omega Fund V GP Manager, the Omega Directors and Annie Mitsak disclaims beneficial ownership of the securities reported herein, except to the extent of its or their pecuniary interest therein, if any.