0000899243-21-004969.txt : 20210204 0000899243-21-004969.hdr.sgml : 20210204 20210204191359 ACCESSION NUMBER: 0000899243-21-004969 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201231 FILED AS OF DATE: 20210204 DATE AS OF CHANGE: 20210204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Machiels Alec CENTRAL INDEX KEY: 0001496687 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38276 FILM NUMBER: 21592763 MAIL ADDRESS: STREET 1: 505 PARK AVENUE STREET 2: 21ST FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apellis Pharmaceuticals, Inc. CENTRAL INDEX KEY: 0001492422 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 271537290 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 FIFTH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: 617-977-5700 MAIL ADDRESS: STREET 1: 100 FIFTH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2020-12-31 0 0 0 0001492422 Apellis Pharmaceuticals, Inc. APLS 0001496687 Machiels Alec C/O APELLIS PHARMACEUTICALS, INC. 100 FIFTH AVENUE, 3RD FLOOR WALTHAM MA 02451 1 0 0 0 Common Stock 2020-12-02 5 G 0 250000 0.00 D 419544 D Common Stock 2020-12-02 5 G 0 250000 0.00 A 250000 I See footnote Common Stock 1950 I See footnote The shares are held by Bauhaus 1 LLC, which LLC is held by The Irrevocable Agreement of Trust of Alec Machiels (the "Trust"). The reporting person is the managing member of Bauhaus 1 LLC and the trustee of the Trust. Owned by the spouse of the reporting person. /s/ David Watson, attorney-in-fact for Cedric Francois 2021-02-04