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*
Aryeh Jason

(Last) (First) (Middle)
C/O QLT INC.
887 GREAT NORTHERN WAY, SUITE 101

(Street)
VANCOUVER A1 V5T 4 T5

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/04/2012
3. Issuer Name and Ticker or Trading Symbol
QLT INC/BC [ QLT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
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 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)
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.