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*
Aklog Lishan

(Last) (First) (Middle)
ONE GRAND CENTRAL PLACE
SUITE 4600

(Street)
NEW YORK NY 10165

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PAVmed Inc. [ PAVM ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman and CEO
3. Date of Earliest Transaction (Month/Day/Year)
02/14/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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 02/02/2018 G V 34,153 D $0(1) 588,413 D
Common Stock 1,285 I By daughter
Common Stock 1,300 I By son
Common Stock 4,456,570 I By Pavilion Venture Partners LLC(2)
Common Stock 20,000 I By HCFP/AG LLC(3)
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
Employee Stock Option (Right to Buy) $2.01 02/14/2018 A 195,108 (4) 02/14/2028 Common Stock 195,108 $0 195,108 D
1. Name and Address of Reporting Person*
Aklog Lishan

(Last) (First) (Middle)
ONE GRAND CENTRAL PLACE
SUITE 4600

(Street)
NEW YORK NY 10165

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman and CEO
1. Name and Address of Reporting Person*
HCFP/Capital Partners III LLC

(Last) (First) (Middle)
ONE GRAND CENTRAL PLACE
SUITE 4600

(Street)
NEW YORK NY 10165

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Pavilion Venture Partners LLC

(Last) (First) (Middle)
ONE GRAND CENTRAL PLACE
SUITE 4600

(Street)
NEW YORK NY 10165

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The reporting person transferred these shares of common stock by bona fide gift to a third party.
2. Dr. Aklog is a member and sole manager of Pavilion Venture Partners LLC, and has sole voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his proportionate pecuniary interest therein.
3. Dr. Aklog is a co-manager of HCFP/AG LLC, and shares joint voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his pecuniary interest therein.
4. The option vests in 12 equal quarterly installments commencing on March 31, 2018.
Remarks:
The reporting person no longer has a reportable beneficial interest in the following securities, which were included in the reporting person's prior ownership reports: (i) 125,000 shares of common stock and 125,000 warrants distributed by HCFP/Capital Partners IIIB LLC to its members on a pro rata basis (none of which were distributed to the reporting person); and (ii) 87,020 shares of common stock and 387,020 warrants held by HCFP Inc., over which the reporting person ceased to have investment control.
/s/ Dr. Lishan Aklog 02/16/2018
/s/ Dr. Lishan Aklog, as manager of HCFP/Capital Partners III LLC 02/16/2018
/s/ Dr. Lishan Aklog, as manager of Pavilion Venture Partners LLC 02/16/2018
** 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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