-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, G4yVhwdIt8o2O2xoUTwZajHgk2mW7wlEYJyv2f4lbKR6U41Ia37xo7MR+E6IroZq e9cD6sgtMmxvah7mYTmNRQ== 0000919574-10-006140.txt : 20101105 0000919574-10-006140.hdr.sgml : 20101105 20101105162323 ACCESSION NUMBER: 0000919574-10-006140 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101103 FILED AS OF DATE: 20101105 DATE AS OF CHANGE: 20101105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ASSOULINE, ELIAV CENTRAL INDEX KEY: 0001483841 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-17082 FILM NUMBER: 101169063 MAIL ADDRESS: STREET 1: 101 PARK AVENUE STREET 2: 47TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10178 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ANDERSEN MARC CENTRAL INDEX KEY: 0001483848 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-17082 FILM NUMBER: 101169064 MAIL ADDRESS: STREET 1: 101 PARK AVENUE STREET 2: 47TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10178 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: QLT INC/BC CENTRAL INDEX KEY: 0000827809 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: A1 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 887 GREAT NORTHERN WAY STREET 2: - CITY: VANCOUVER STATE: A1 ZIP: V5T 4T5 BUSINESS PHONE: 6047077000 MAIL ADDRESS: STREET 1: 887 GREAT NORTHERN WAY CITY: VANCOUVER STATE: A1 ZIP: V5T 4T5 FORMER COMPANY: FORMER CONFORMED NAME: QLT PHOTO THERAPEUTICS INC DATE OF NAME CHANGE: 19960618 FORMER COMPANY: FORMER CONFORMED NAME: QUADRA LOGIC TECHNOLOGIES INC DATE OF NAME CHANGE: 19941201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AXIAL CAPITAL MANAGEMENT, LLC CENTRAL INDEX KEY: 0001351143 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-17082 FILM NUMBER: 101169065 BUSINESS ADDRESS: STREET 1: 101 PARK AVENUE STREET 2: 47TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10178 BUSINESS PHONE: 212-984-2100 MAIL ADDRESS: STREET 1: 101 PARK AVENUE STREET 2: 47TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10178 4 1 p1144663.xml SECOND CURVE/QLT X0303 4 2010-11-03 0 0000827809 QLT INC/BC QLTI 0001351143 AXIAL CAPITAL MANAGEMENT, LLC 101 PARK AVENUE 48TH FLOOR NEW YORK NY 10178 0 0 1 0 0001483848 ANDERSEN MARC 101 PARK AVENUE 48TH FLOOR NEW YORK NY 10178 0 0 1 0 0001483841 ASSOULINE, ELIAV 101 PARK AVENUE 48TH FLOOR NEW YORK NY 10178 0 0 1 0 Common Stock 2010-11-03 4 P 0 2600 5.6 A 6788636 I See Footnote The reported securities are directly owned by certain private investment vehicles managed by Axial Capital Management LLC and may be deemed beneficially owned by Axial Capital Management LLC as the investment manager of such private investment vehicles. The reported securities also may be deemed beneficially owned by Marc Andersen and Eliav Assouline as the Managing Members of Axial Capital Management LLC. Each such Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his or its pecuniary interest therein, and this report shall not be deemed an admission that such Reporting Person is the beneficial owner of the securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose. Axial Capital Management LLC, By: /s/ Eliav Assouline, Managing Member 2010-11-05 /s/ Marc Andersen 2010-11-05 /s/ Eliav Assouline 2010-11-05 -----END PRIVACY-ENHANCED MESSAGE-----