0000899243-19-013252.txt : 20190513 0000899243-19-013252.hdr.sgml : 20190513 20190513170058 ACCESSION NUMBER: 0000899243-19-013252 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190509 FILED AS OF DATE: 20190513 DATE AS OF CHANGE: 20190513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Richard King Mellon Foundation CENTRAL INDEX KEY: 0001774767 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38886 FILM NUMBER: 19819176 BUSINESS ADDRESS: STREET 1: P.O. BOX 945 CITY: LIGONIER STATE: PA ZIP: 15658 BUSINESS PHONE: 724-238-8466 MAIL ADDRESS: STREET 1: P.O. BOX 945 CITY: LIGONIER STATE: PA ZIP: 15658 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Trevi Therapeutics, Inc. CENTRAL INDEX KEY: 0001563880 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 450834299 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 195 CHURCH STREET STREET 2: 14TH FLOOR CITY: NEW HAVEN STATE: CT ZIP: 06510 BUSINESS PHONE: 203-304-2499 MAIL ADDRESS: STREET 1: 195 CHURCH STREET STREET 2: 14TH FLOOR CITY: NEW HAVEN STATE: CT ZIP: 06510 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-05-09 1 0001563880 Trevi Therapeutics, Inc. TRVI 0001774767 Richard King Mellon Foundation C/O TREVI THERAPEUTICS, INC. 195 CHURCH STREET, 14TH FLOOR NEW HAVEN CT 06510 0 0 1 0 Common Stock 2019-05-09 4 C 0 222816 A 222816 D Common Stock 2019-05-09 4 J 0 24341 0.00 A 247157 D Common Stock 2019-05-09 4 P 0 100000 10.00 A 347157 D Series C Preferred Stock 2019-05-09 4 C 0 1908450 0.00 D Common Stock 222816 0 D 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. Consists of shares transferred to Richard King Mellon Foundation by TPG Biotechnology Partners III, L.P. in connection with the closing of the Issuer's initial public offering. /s/ Douglas L. Sisson, Vice President and Treasurer 2019-05-09