0001712599-17-000001.txt : 20170830 0001712599-17-000001.hdr.sgml : 20170830 20170830172327 ACCESSION NUMBER: 0001712599-17-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170824 FILED AS OF DATE: 20170830 DATE AS OF CHANGE: 20170830 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Smith Robin L CENTRAL INDEX KEY: 0001365035 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54600 FILM NUMBER: 171061479 MAIL ADDRESS: STREET 1: C/O PHASE III MEDICAL, INC. STREET 2: 330 SOUTH SERVICE ROAD, SUITE 120 CITY: MELVILLE STATE: NY ZIP: 11747 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PROLUNG INC CENTRAL INDEX KEY: 0001541884 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 201922768 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 757 EAST SOUTH TEMPLE, SUITE 150 CITY: SALT LAKE CITY STATE: UT ZIP: 84102 BUSINESS PHONE: 801-204-9623 MAIL ADDRESS: STREET 1: 757 EAST SOUTH TEMPLE, SUITE 150 CITY: SALT LAKE CITY STATE: UT ZIP: 84102 FORMER COMPANY: FORMER CONFORMED NAME: FRESH MEDICAL LABORATORIES, INC. DATE OF NAME CHANGE: 20120209 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-08-24 0 0001541884 PROLUNG INC [None] 0001365035 Smith Robin L C/O PHASE III MEDICAL, INC. 330 SOUTH SERVICE ROAD, SUITE 120 MELVILLE NY 11747 1 0 0 1 Nominating Committee Chair Employee Stock Option (right to buy) 1 2017-08-24 4 A 0 20000 0 A 2017-08-24 2027-08-24 Common Stock 20000 20000 D Employee Stock Option (right to buy) 1 2017-08-24 4 A 0 30000 0 A 2027-08-24 Common Stock 30000 30000 D Employee Stock Option (right to buy) 1.25 2017-08-24 4 A 0 70000 0 A 2017-08-24 2027-08-24 Common Stock 70000 70000 D The option vests in four equal quarterly installments: September 30, 2017; December 31, 2017; March 31, 2018; and June 30, 2018. Robin L. Smith 2017-08-30