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*
PTV SCIENCES II L P

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Apollo Endosurgery, Inc. [ APEN ]
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)
09/05/2017
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 09/05/2017 P 41,000 A $4.04 1,131,909 I By PTV Evergreen Fund, L.P.(1)
Common Stock 09/12/2017 P 135,000 A $3.85 1,266,909 I By PTV Evergreen Fund, L.P.(1)
Common Stock 2,199,186 I By PTV Sciences II, L.P.(2)
Common Stock 1,347,565 I By PTV IV, L.P.(3)
Common Stock 605,712 I By PTV Special Opportunities I, L.P.(4)
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
1. Name and Address of Reporting Person*
PTV SCIENCES II L P

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
PTV IV, L.P.

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
PTV Special Opportunities I, L.P.

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
PTV Evergreen Fund, L.P.

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Pinto Technology Ventures GP II, L.P.

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
PTV GP IV, L.P.

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
PTV GP SO I, L.P.

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
PTV GP Evergreen, L.P.

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Pinto TV GP CO LLC

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
1. Name and Address of Reporting Person*
PTV GP III Management, LLC

(Last) (First) (Middle)
3600 N CAPITAL OF TEXAS HWY, SUITE B180

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
Explanation of Responses:
1. These securities are owned by PTV Evergreen Fund, L.P. ("PTV EG"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP Evergreen, L.P. ("PTV GP EG"), which is the sole general partner of PTV EG. Accordingly, PTV GP EG and PTV GPM may be deemed to have voting and investment control over the shares owned by PTV EG. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV EG. Each of PTV GP EG and PTV GPM disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
2. These securities are owned by PTV Sciences II, L.P. ("PTV II"). Pinto TV GP Company LLC ("PTV GPC") is the sole general partner of Pinto Technology Ventures GP II, L.P. ("PTV GP II"), which is the sole general partner of PTV II. Accordingly, PTV GP II and PTV GPC may be deemed to have voting and investment control over the shares owned by PTV II. The managers of PTV GPC are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV II. Each of PTV GP II and PTV GPC disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
3. These securities are owned by PTV IV, L.P. ("PTV IV"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP IV, L.P. ("PTV GP IV"), which is the sole general partner of PTV IV. Accordingly, PTV GP IV and PTV GPM may be deemed to have voting and investment control over the shares owned by PTV IV. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV IV. Each of PTV GP IV and PTV GPM disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
4. These securities are owned by PTV Special Opportunities I, L.P. ("PTV SO"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP SO I, L.P. ("PTV GP SO"), which is the sole general partner of PTV SO. Accordingly, PTV GP SO and PTV GPM may be deemed to have voting and investment control over the shares owned by PTV SO. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV SO. Each of PTV GP SO and PTV GPM disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
Remarks:
Matthew S. Crawford and Rick D. Anderson are both directors of the Issuer and accordingly file separate Section 16 reports.
PTV Sciences II, L.P., By: Pinto Technology Ventures GP II, L.P., its general partner, By: Pinto TV GP Company LLC, its general partner, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
PTV IV, L.P., By: PTV GP IV, L.P., its general partner, By: PTV GP III Management, LLC, its general partner, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
PTV Special Opportunities I, L.P., By: PTV GP SO I, L.P., its general partner, By: PTV GP III Management, LLC, its general partner, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
PTV Evergreen Fund, L.P., By: PTV GP Evergreen, L.P., its general partner, By: PTV GP III Management, LLC, its general partner, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
Pinto Technology Ventures GP II, L.P., By: Pinto TV GP Company LLC, its general partner, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
PTV GP IV, L.P., By: PTV GP III Management, LLC, its general partner, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
PTV GP SO I, L.P., By: PTV GP III Management, LLC, its general partner, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
PTV GP Evergreen, L.P., By: PTV GP III Management, LLC, its general partner, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
Pinto TV GP Company LLC, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
PTV GP III Management, LLC, By: /s/ Matthew S. Crawford, Its: Manager 09/25/2017
** 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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