SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
BLATT LAWRENCE

(Last) (First) (Middle)
C/O ALIGOS THERAPEUTICS, INC.
1 CORPORATE DRIVE, 2ND FLOOR

(Street)
SOUTH SAN FRANCISCO CA 94080

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/15/2020
3. Issuer Name and Ticker or Trading Symbol
Aligos Therapeutics, Inc. [ ALGS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 1,237,298(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (2) 02/19/2030 Common Stock 210,717(1) $3.45(1) D
Stock Option (Right to Buy) (2) 02/19/2030 Common Stock 647,679(1) $3.45(1) D
Series A Preferred Stock (3) (3) Common Stock 41,016(1)(3) (3) I Trust(4)
Series A Preferred Stock (3) (3) Common Stock 122,601(1)(3) (3) I Trust(5)
Series A Preferred Stock (3) (3) Common Stock 13,671(1)(3) (3) I Trust(6)
Series A Preferred Stock (3) (3) Common Stock 13,671(1)(3) (3) I Trust(7)
Series B-1 Preferred Stock (3) (3) Common Stock 50,712(1)(3) (3) I Trust(4)
Series B-1 Preferred Stock (3) (3) Common Stock 3,394(1)(3) (3) I Trust(6)
Series B-1 Preferred Stock (3) (3) Common Stock 3,394(1)(3) (3) I Trust(7)
Series B-2 Preferred Stock (3) (3) Common Stock 21,695(1)(3) (3) I Trust(4)
Series B-2 Preferred Stock (3) (3) Common Stock 1,452(1)(3) (3) I Trust(6)
Series B-2 Preferred Stock (3) (3) Common Stock 1,452(1)(3) (3) I Trust(7)
Explanation of Responses:
1. Reflects a 1-for-9.3197 reverse stock split of the Issuer's outstanding securities effected prior to the effectiveness of the Issuer's S-1 Registration Statement.
2. The shares subject to the option are early exercisable. 1/48th of the total number of shares vest in forty-eight (48) successive and equal monthly installments measured from December 23, 2019 (the "Vesting Commencement Date"), such that 100% of the shares subject to the option will be fully vested and exercisable on the fourth anniversary of the Vesting Commencement Date.
3. At any time at the holder's election or automatically upon the closing of the Issuer's initial public offering, shares of the Issuer's preferred stock will convert into shares of the Issuer's common stock on a one for one basis without payment or consideration. The preferred stock has no expiration date.
4. Lawrence M. Blatt Living Trust dated 8/27/14.
5. PENSCO Trust Company LLC Custodian FBO Dr. Lawrence Blatt IRA
6. Zachary David Blatt Irrevocable Trust dated 8/24/14.
7. Zoe Anne Blatt Irrevocable Trust dated 8/24/14.
/s/ Lucinda Y. Quan, as attorney-in fact for Lawrence M. Blatt 10/15/2020
** 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 5 (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.