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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/04/2012 |
3. Issuer Name and Ticker or Trading Symbol
QLT INC/BC [ QLT ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 Shares, without par value | 151,078 | I | By JALAA Equities, LP(1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Short Put Option (obligation to buy) | (2) | 06/16/2012 | Common Stock | 2,500 | $10 | I | By JALAA Equities, LP(1) |
Short Put Option (obligation to buy) | (3) | 06/16/2012 | Common Stock | 2,000 | $5 | I | By JALAA Equities, LP(1) |
Short Put Option (obligation to buy) | (4) | 06/16/2012 | Common Stock | 44,700 | $7.5 | I | By JALAA Equities, LP(1) |
Short Put Option (obligation to buy) | 05/07/2012 | 09/22/2012 | Common Stock | 1,000 | $10 | I | By JALAA Equities, LP(1) |
Short Put Option (obligation to buy) | (5) | 09/22/2012 | Common Stock | 21,000 | $7.5 | I | By JALAA Equities, LP(1) |
Short Put Option (obligation to buy) | 05/15/2012 | 09/22/2012 | Common Stock | 2,000 | $5 | I | By JALAA Equities, LP(1) |
Short Put Option (obligation to buy) | 05/07/2012 | 12/22/2012 | Common Stock | 500 | $10 | I | By JALAA Equities, LP(1) |
Short Put Option (obligation to buy) | (6) | 12/22/2012 | Common Stock | 33,000 | $5 | I | By JALAA Equities, LP(1) |
Short Put Option (obligation to buy) | (7) | 12/22/2012 | Common Stock | 12,500 | $7.5 | I | By JALAA Equities, LP(1) |
Explanation of Responses: |
1. All securities disclosed in this Form 3 are owned by JALAA Equities, LP, of which Jason Aryeh is the General Partner. By reason of the provisions of Rule 16a-1 under the Securities Exchange Act of 1934, as amended, Mr. Aryeh may be deemed to be the beneficial owner of the securities owned by JALAA Equities, LP. |
2. Purchased in a series of transactions from April 10, 2012 through May 7, 2012. |
3. Purchased in a series of transactions from October 24, 2011 through October 25, 2011. |
4. Purchased in a series of transactions from October 31, 2011 through May 7, 2012. |
5. Purchased in a series of transactions from March 2, 2012 through May 9, 2012. |
6. Purchased in a series of transactions from May 4, 2012 through May 15, 2012. |
7. Purchased in a series of transactions from May 3, 2012 through May 9, 2012. |
Remarks: |
Exhibit List: Exhibit 24 -- Power of Attorney |
/s/ Jason Aryeh | 06/13/2012 | |
** 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. |