0001104659-22-130631.txt : 20221228 0001104659-22-130631.hdr.sgml : 20221228 20221228211059 ACCESSION NUMBER: 0001104659-22-130631 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221227 FILED AS OF DATE: 20221228 DATE AS OF CHANGE: 20221228 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lizak Carol R. CENTRAL INDEX KEY: 0001785794 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36714 FILM NUMBER: 221496173 MAIL ADDRESS: STREET 1: 201 MISSION STREET, SUITE 2375 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jaguar Health, Inc. CENTRAL INDEX KEY: 0001585608 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 200 PINE STREET SUITE 400 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 BUSINESS PHONE: 415-371-8300 MAIL ADDRESS: STREET 1: 200 PINE STREET SUITE 400 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 FORMER COMPANY: FORMER CONFORMED NAME: Jaguar Animal Health, Inc. DATE OF NAME CHANGE: 20130830 4 1 tm2233639-1_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2022-12-27 0 0001585608 Jaguar Health, Inc. JAGX 0001785794 Lizak Carol R. C/O JAGUAR HEALTH, INC. 200 PINE STREET, SUITE 400 SAN FRANCISCO CA 94104 0 1 0 0 Chief Financial Officer Employee Stock Option (right to buy) 5.97 2022-12-27 4 D 0 14294 0 D 2031-04-05 Common Stock 14294 0 D The option was cancelled by mutual agreement of the reporting person and Jaguar Health, Inc. The reporting person received $300 as consideration for the cancellation. The option will vest ratably on a monthly basis over 36 months from the grant date, so long as the executive remains employed by the issuer. /s/ Carol R. Lizak 2022-12-28