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)
06/12/2018
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 588,413 D
Common Stock 06/12/2018 X 1,018 A (1) 2,303 I By daughter
Common Stock 06/12/2018 X 980 A (1) 2,280 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
Series Z Warrants $1.6 04/20/2018 G V 12,450 04/05/2018 04/30/2024 Common Stock 12,450 $0 363,313(4) D
Subscription Rights (Right to Buy) $1.15 06/12/2018 X 1,018 05/23/2018 06/12/2018 Units (1 share of Common Stock and 1 Series Z Warrant) 1,018 $0 0 I By daughter
Series Z Warrants $1.6 06/12/2018 X 1,018 04/05/2018 04/30/2024 Common Stock 1,018 (1) 1,018 I By daughter
Subscription Rights (Right to Buy) $1.15 06/12/2018 X 980 05/23/2018 06/12/2018 Units (1 share of Common Stock and 1 Series Z Warrant) 980 $0 0 I By son
Series Z Warrants $1.6 06/12/2018 X 980 04/05/2018 04/30/2024 Common Stock 980 (1) 980 I By son
Series Z Warrants $1.6 06/26/2018 J 968,019 04/05/2018 04/30/2024 Common Stock 2,078,285 (5) 2,078,285 I By Pavilion Venture Partners LLC(2)
Series Z Warrants $1.6 04/05/2018 04/30/2024 Common Stock 10,000 10,000 I By HCFP/AG LLC(3)
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*
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 purchased units from the issuer in the issuer's equity rights offering, each unit consisting of one share of the issuer's common stock and one Series Z Warrant, at a price of $1.15 per unit.
2. Dr. Aklog is a member and sole manager of Pavilion Venture Partners LLC, and has sole voting and dispositive power over the securities held by this entity. Dr. Aklog disclaims beneficial ownership of securities 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 securities held by this entity. Dr. Aklog disclaims beneficial ownership of securities held by this entity, except to the extent of his pecuniary interest therein.
4. Reflects 350,538 Series Z Warrants that previously were held indirectly by Dr. Aklog through HCFP/Capital Partners III LLC, and became held directly by Dr. Aklog on June 26, 2018.
5. The Series Z Warrants were contributed to such entity by its members for no consideration. The contributed Series Z Warrants include 322,673 Series Z Warrants that were previously held indirectly by Dr. Aklog through HCFP/Capital Partners III LLC and became held directly by Dr. Aklog on June 26, 2016.
Remarks:
/s/ Dr. Lishan Aklog 07/11/2018
/s/ Dr. Lishan Aklog, as manager of Pavilion Venture Partners LLC 07/11/2018
** 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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