0001104659-16-139279.txt : 20160812 0001104659-16-139279.hdr.sgml : 20160812 20160812131908 ACCESSION NUMBER: 0001104659-16-139279 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160810 FILED AS OF DATE: 20160812 DATE AS OF CHANGE: 20160812 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Gemphire Therapeutics Inc. CENTRAL INDEX KEY: 0001638287 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 472389984 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 43334 7 MILE ROAD STREET 2: SUITE 1000 CITY: NORTHVILLE STATE: MI ZIP: 48167 BUSINESS PHONE: 248-980-6538 MAIL ADDRESS: STREET 1: 43334 7 MILE ROAD STREET 2: SUITE 1000 CITY: NORTHVILLE STATE: MI ZIP: 48167 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LICHTINGER PEDRO CENTRAL INDEX KEY: 0001470741 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37809 FILM NUMBER: 161827439 MAIL ADDRESS: STREET 1: 1301 HARBOR BAY PARKWAY CITY: ALAMEDA STATE: CA ZIP: 94502 4 1 a4.xml 4 X0306 4 2016-08-10 0 0001638287 Gemphire Therapeutics Inc. GEMP 0001470741 LICHTINGER PEDRO 43334 SEVEN MILE ROAD SUITE 1000 NORTHVILLE MI 48167 1 0 0 0 Common Stock 2016-08-10 4 C 0 39274 6.7059 A 39274 D Common Stock 2016-08-10 4 P 0 10000 10.00 A 49274 D 8% Convertible Subordinated Promissory Note 6.7059 2016-08-10 4 C 0 250000 0 D Common Stock 39274 0 D The note was issued in the original principal amount of $250,000. The outstanding principal and $13,370 of accrued interest on the note automatically converted into shares of Common Stock immediately prior to the closing of the Company's initial public offering. /s/ Stephanie Swan, by Power of Attorney 2016-08-12