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
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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*
Hendricks Diane

(Last) (First) (Middle)
C/O 1000 STOKIE BLVD. STE 350

(Street)
WILMETTE IL

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Monopar Therapeutics [ MNPR ]
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)
12/18/2019
4. 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 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 12/18/2019 P 468,750 A $8 468,750 I See Footnote 1(1)
Common stock 3,055,394.12 I See Footnote 2(2)
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
Explanation of Responses:
1. This is based upon the 468,750 shares of Monopar Common Stock that DMH Business LLC directly owns. As a manager of DMH Business LLC, Ms. Hendricks may be deemed to share voting and dispositive power over these 468,750 shares. Ms. Hendricks disclaims beneficial ownership of the 468,750 shares held by DMH Business LLC, except to the extent of her pecuniary interest therein.
2. Gem Pharmaceuticals LLC ("Gem"), an Alabama limited liability company, has voting and investment power over 3,055,394.12 of the shares of common stock held by TacticGem LLC. Diane Hendricks is a manager of Gem and along with other managers collectively have voting control over the securities described herein. Pharma Investments LLC ("Pharma") owns a controlling share of Gem and Diane Hendricks owns a controlling share of Pharma, so Pharma and its controlling shareholders have indirect control over the securities described herein. The managers of Gem and the controlling shareholders of Pharma each disclaim ownership of the shares of common stock owned by Gem, except to the extent of their pecuniary interest therein.
/s/ Kim R. Tsuchimoto, Attorney-in-fact 12/20/2019
** 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).
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