SEC FORM
4
SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
|
|
|
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
Denali Therapeutics Inc.
[ DNLI ]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
3. Date of Earliest Transaction
(Month/Day/Year) 12/12/2017
|
4. 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 Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
|
2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
|
4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
|
5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
|
7. Nature of Indirect Beneficial Ownership (Instr.
4)
|
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
12/12/2017 |
|
C |
|
14,499,999 |
A |
|
14,812,499 |
I |
By AKDL, L.P.
|
Common Stock |
12/12/2017 |
|
C |
|
2,500,000 |
A |
|
17,312,499 |
I |
By AKDL, L.P.
|
Common Stock |
12/12/2017 |
|
C |
|
1,875,000 |
A |
|
19,187,499 |
I |
By AKDL, L.P.
|
Common Stock |
12/12/2017 |
|
C |
|
743,599 |
A |
|
743,599 |
I |
By Neuro Line Partners, L.P.
|
Common Stock |
12/12/2017 |
|
C |
|
128,200 |
A |
|
871,799 |
I |
By Neuro Line Partners, L.P.
|
Common Stock |
12/12/2017 |
|
C |
|
240,000 |
A |
|
1,111,799 |
I |
By Neuro Line Partners, L.P.
|
Common Stock |
12/12/2017 |
|
P |
|
275,000 |
A |
$18
|
19,462,499 |
I |
By AKDL, L.P.
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivative Security (Instr.
3)
|
2. Conversion or Exercise Price of Derivative Security
|
3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction 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
(Month/Day/Year) |
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: 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 |
Series A-1 Convertible Preferred Stock |
|
12/12/2017 |
|
C |
|
|
14,499,999 |
|
|
Common Stock |
14,499,999 |
$0.00
|
0 |
I |
By AKDL, L.P.
|
Series A-2 Convertible Preferred Stock |
|
12/12/2017 |
|
C |
|
|
2,500,000 |
|
|
Common Stock |
2,500,000 |
$0.00
|
0 |
I |
By AKDL, L.P.
|
Series B-1 Convertible Preferred Stock |
|
12/12/2017 |
|
C |
|
|
1,875,000 |
|
|
Common Stock |
1,875,000 |
$0.00
|
0 |
I |
By AKDL, L.P.
|
Series A-1 Convertible Preferred Stock |
|
12/12/2017 |
|
C |
|
|
743,599 |
|
|
Common Stock |
743,599 |
$0.00
|
0 |
I |
By Neuro Line Partners, L.P.
|
Series A-2 Convertible Preferred Stock |
|
12/12/2017 |
|
C |
|
|
128,200 |
|
|
Common Stock |
128,200 |
$0.00
|
0 |
I |
By Neuro Line Partners, L.P.
|
Series B-1 Convertible Preferred Stock |
|
12/12/2017 |
|
C |
|
|
240,000 |
|
|
Common Stock |
240,000 |
$0.00
|
0 |
I |
By Neuro Line Partners, L.P.
|
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
1. Name and Address of Reporting Person*
201 MAIN STREET, SUITE 1900 |
|
(Street)
|
Explanation of Responses: |
Remarks: |
|
DOUGLAS K. BRATTON, Name: /s/ Douglas K. Bratton |
12/14/2017 |
|
AKDL, L.P., By: Crestline SI (GP), L.P., its general partner, By: Crestline Investors, Inc., its general partner, Name: /s/ Douglas K. Bratton, Title: Sole Director |
12/14/2017 |
|
NEURO LINE PARTNERS, L.P., By: Bratton Capital Management, L.P., its general partner, By: Bratton Capital, Inc., its, its general partner, Name: /s/ Douglas K. Bratton, Title: Sole Director |
12/14/2017 |
|
CRESTLINE SI (GP), L.P., By: Crestline Investors, Inc., its general partner, Name: /s/ Douglas K. Bratton, Title: Sole Director |
12/14/2017 |
|
CRESTLINE INVESTORS, INC., Name: /s/ Douglas K. Bratton, Title: Sole Director |
12/14/2017 |
|
BRATTON CAPITAL MANAGEMENT, L.P., By: Bratton Capital, Inc., its general partner, Name: /s/ Douglas K. Bratton, Title: Sole Director |
12/14/2017 |
|
BRATTON CAPITAL, INC., Name: /s/ Douglas K. Bratton, Title: Sole Director |
12/14/2017 |
|
CRESTLINE MANAGEMENT, L.P., By: Crestline Investors, Inc., its general partner, Name: /s/ Douglas K. Bratton, Title: Sole Director |
12/14/2017 |
|
** 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
4
(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. |
Exhibit 99
Form 4 Joint Filer Information
Name: AKDL, L.P.
Address: 201 Main Street, Suite 1900
Fort Worth, TX 76102
Date of Event Requiring Statement: 12/12/17
Name: Neuro Line Partners, L.P.
Address: 201 Main Street, Suite 1900
Fort Worth, TX 76102
Date of Event Requiring Statement: 12/12/17
Name: Crestline SI (GP), L.P.
Address: 201 Main Street, Suite 1900
Fort Worth, TX 76102
Date of Event Requiring Statement: 12/12/17
Name: Crestline Investors, Inc.
Address: 201 Main Street, Suite 1900
Fort Worth, TX 76102
Date of Event Requiring Statement: 12/12/17
Name: Bratton Capital Management, L.P.
Address: 201 Main Street, Suite 1900
Fort Worth, TX 76102
Date of Event Requiring Statement: 12/12/17
Name: Bratton Capital, Inc.
Address: 201 Main Street, Suite 1900
Fort Worth, TX 76102
Date of Event Requiring Statement: 12/12/17
Name: Crestline Management, L.P.
Address: 201 Main Street, Suite 1900
Fort Worth, TX 76102
Date of Event Requiring Statement: 12/12/17