0001209191-14-068350.txt : 20141112 0001209191-14-068350.hdr.sgml : 20141111 20141112203743 ACCESSION NUMBER: 0001209191-14-068350 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141109 FILED AS OF DATE: 20141112 DATE AS OF CHANGE: 20141112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Xenon Pharmaceuticals Inc. CENTRAL INDEX KEY: 0001582313 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 980661854 STATE OF INCORPORATION: A1 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 200 - 3650 GILMORE WAY CITY: BURNABY STATE: A1 ZIP: V5G 48W BUSINESS PHONE: (604) 484-3300 MAIL ADDRESS: STREET 1: 200 - 3650 GILMORE WAY CITY: BURNABY STATE: A1 ZIP: V5G 48W REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HOLLER FRANK A CENTRAL INDEX KEY: 0000938801 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36687 FILM NUMBER: 141216007 MAIL ADDRESS: STREET 1: SUITE 707 STREET 2: 1177 WEST HASTINGS ST CITY: VANCOVER BRITISH COL STATE: A1 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2014-11-09 0 0001582313 Xenon Pharmaceuticals Inc. XENE 0000938801 HOLLER FRANK A C/O XENON PHARMACEUTICALS INC. 200 - 3650 GILMORE WAY BURNABY A1 V5G 4W8 BRITISH COLUMBIA, CANADA 1 0 0 0 Common Shares 2014-11-09 4 C 0 95002 A 165893 D Common Shares 2014-11-09 4 C 0 4988 A 170881 D Common Shares 2014-11-09 4 C 0 2737 A 173618 D Common Shares 2014-11-09 4 C 0 941 A 1184 I By wife Series A Preferred Shares 2014-11-09 4 C 0 95002 0.00 D Common Shares 95002 0 D Series A Preferred Shares 2014-11-09 4 C 0 941 0.00 D Common Shares 941 0 I By wife Series B Preferred Shares 2014-11-09 4 C 0 4988 0.00 D Common Shares 4988 0 D Series E Preferred Shares 2014-11-09 4 C 0 2737 0.00 D Common Shares 2737 0 D The Series A Preferred Shares and Series B Preferred Shares converted into Common Shares on a 1-for-1 basis immediately prior to the completion of the Issuer's initial public offering of Common Shares and had no expiration date. The Series E Preferred Shares converted into Common Shares on a 1.2-for-1 basis immediately prior to the completion of the Issuer's initial public offering of Common Shares and had no expiration date. /s/ Barbara A. Mery, Attorney-in-fact 2014-11-12