0001144204-16-083990.txt : 20160224 0001144204-16-083990.hdr.sgml : 20160224 20160224120617 ACCESSION NUMBER: 0001144204-16-083990 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20160224 DATE AS OF CHANGE: 20160224 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GLOBEIMMUNE INC CENTRAL INDEX KEY: 0001245104 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 841353925 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-88221 FILM NUMBER: 161451002 BUSINESS ADDRESS: STREET 1: 1450 INFINITE DRIVE CITY: LOUISVILLE STATE: CO ZIP: 80027 BUSINESS PHONE: 3036252744 MAIL ADDRESS: STREET 1: 1450 INFINITE DRIVE CITY: LOUISVILLE STATE: CO ZIP: 80027 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Bartelt Jeffrey W CENTRAL INDEX KEY: 0001667844 FILING VALUES: FORM TYPE: SC 13G MAIL ADDRESS: STREET 1: 1675 N. 122ND STREET CITY: WAUWATOSA STATE: WI ZIP: 53226 SC 13G 1 v432619_sc13g.htm SC 13G

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

 

SCHEDULE 13G

 

Under the Securities Exchange Act of 1934
(Amendment No. ________)*

 

GlobeImmune, Inc.

 

(Name of Issuer)

 

Common Stock, $0.001 par value per share

(Title of Class of Securities)

 

37957B100

(CUSIP Number)

 

Heather M. Downs Russell, Whyte Hirschboeck Dudek S.C., 555 East Wells Street, Suite 1900, Milwaukee, WI 53202; (414) 273-2100

 

(Name, Address and Telephone Number of Person
Authorized to Receive Notices and Communications)

 

February 18, 2016

 (Date of Event which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

 


¨  Rule 13d-1(b)
x  Rule 13d-1(c)
¨  Rule 13d-1(d)

 

* The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.

 

The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 

 

CUSIP No. 37957B 10 013G Page 2 of 5 Pages

  

         
1.   NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)

Jeffrey Wm. Bartelt		    
2.   CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(see instructions)
(a)    ¨
(b)    ¨		    
3.   SEC USE ONLY
 		    
4.   CITIZENSHIP OR PLACE OF ORGANIZATION
 
U.S. Citizen		    

 

         
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH   5.   SOLE VOTING POWER
 
300,200 shares
  6.   SHARED VOTING POWER
 
0 shares
  7.   SOLE DISPOSITIVE POWER
 
300,200 shares
  8.   SHARED DISPOSITIVE POWER
 
0 shares

         
9.   AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

300,200 shares		    
10.   CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES
(see instructions)    ¨		    
11.   PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

5.2%		    
12.  

TYPE OF REPORTING PERSON (see instructions)


IN

    
         

 

 

CUSIP No. 37957B 10 013G Page 3 of 5 Pages

 

Item 1.

 

  (a)

Name of Issuer:


GlobeImmune, Inc., a Delaware corporation (the “Issuer”).

     
  (b)

Address of Issuer’s Principal Executive Offices:


1450 Infinite Drive

Louisville, CO 80027

 

Item 2.

 

  (a)

Name of Person Filing:

 

Jeffrey Wm. Bartelt

     
  (b)

Address of the Principal Office or, if none, residence:


1675 N. 122nd Street, Wauwatosa, WI 53226

     
  (c)

Citizenship:


U.S. Citizen

     
  (d)

Title of Class of Securities:


Common Stock, par value $0.001 per share (the “Common Stock”)

     
  (e)

CUSIP Number:


37957B100

     

 

Item 3.  If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:

 

Not applicable.

 

  (a) ¨ Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o).
       
  (b) ¨ Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c).
       
  (c) ¨ Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c).
       
  (d) ¨ Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8).
       
  (e) ¨ An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E);
       
  (f) ¨ An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F);
       
  (g) ¨ A parent holding company or control person in accordance with §240.13d-1(b)(1)(ii)(G);
       
  (h) ¨ A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);
       
  (i) ¨ A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3);
       
  (j) ¨ Group, in accordance with §240.13d-1(b)(1)(ii)(J).
       

 

 

CUSIP No. 37957B 10 013G Page 4 of 5 Pages

  

Item 4.  Ownership.

 

Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.

 

       
  (a)

Amount beneficially owned:  

 

As of the close of business on February 18, 2016, Jeffrey Wm. Bartelt beneficially owned 300,200 shares of Common Stock.

       
  (b)

Percent of class: 

 

As of the close of business on February 18, 2016, Jeffrey Wm. Bartelt beneficially owned approximately 5.2% of the outstanding shares of Common Stock.

       
  (c) Number of shares as to which the person has: 
       
    (i) Sole power to vote or to direct the vote:  300,200 shares
       
    (ii) Shared power to vote or to direct the vote:  0 shares
       
    (iii) Sole power to dispose or to direct the disposition of:  300,200 shares
       
    (iv) Shared power to dispose or to direct the disposition of:  0 shares

 

Instruction. For computations regarding securities which represent a right to acquire an underlying security see §240.13d-3(d)(1).

 

Item 5.  Ownership of Five Percent or Less of a Class.

 

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following     ¨.

 

Not applicable.

 

Instruction. Dissolution of a group requires a response to this item.

 

Item 6.  Ownership of More than Five Percent on Behalf of Another Person.

 

Not applicable.

 

Item 7.  Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company.

 

Not applicable.

 

Item 8.  Identification and Classification of Members of the Group.

 

Not applicable.

 

Item 9.  Notice of Dissolution of Group.

 

Not applicable.

 

Item 10.  Certification.

 

By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.

 

 

CUSIP No. 37957B 10 013G Page 5 of 5 Pages

 

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

 

   
 

February 24, 2016

Date

   
 

/s/ Heather M. Downs Russell Attorney-in-Fact

Heather M. Downs Russell

Attorney-In-Fact