UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series B Preferred Stock | Â (1) | Â (1) | Common Stock | 72,087 | $ (1) | D | Â |
Series B-1 Preferred Stock | Â (1) | Â (1) | Common Stock | 189,159 | $ (1) | D | Â |
Series C Preferred Stock | Â (1) | Â (1) | Common Stock | 783,332 | $ (1) | D | Â |
Series C Preferred Stock | Â (1) | Â (1) | Common Stock | 41,665 | $ (1) | I | See footnote (2) |
Series C Preferred Stock | Â (1) | Â (1) | Common Stock | 41,665 | $ (1) | I | See footnote (3) |
Series C Preferred Stock | Â (1) | Â (1) | Common Stock | 41,665 | $ (1) | I | See footnote (4) |
Series C Preferred Stock | Â (1) | Â (1) | Common Stock | 41,665 | $ (1) | I | See Footnote (5) |
Series C Preferred Stock | Â (1) | Â (1) | Common Stock | 41,665 | $ (1) | I | See footnote (6) |
Common Stock Warrant | Â (7) | 10/31/2016 | Common Stock | 27,074 | $ 0.024 | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SCHULER JACK W C/O NEOS THERAPEUTICS, INC. 2940 N. HIGHWAY 360 GRAND PRAIRIE, TX 75050 |
 |  X |  |  |
/s/ Benjamin Piper, attorney-in-fact | 07/22/2015 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The Series B preferred stock, Series B-1 preferred stock and Series C preferred stock are convertible into common stock on a 2.4-for-1 basis into the number of shares of common stock as shown in column 3 at any time at the holder's election, and automatically upon the closing of the Issuer's initial public offering. The Series B preferred stock, Series B-1 preferred stock and Series C preferred stock have no expiration date. |
(2) | Security listed in column 1 is directly held by JS Grandchildren 2010 Continuation Trust. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
(3) | Security listed in column 1 is directly held by Schuler Grandchildren LLC. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
(4) | Security listed in column 1 is directly held by Tanya Eve Schuler Trust. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
(5) | Security listed in column 1 is directly held by Therese Heidi Schuler Trust. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
(6) | Security listed in column 1 is directly held by Tino Hans Schuler Trust. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
(7) | The warrant is exercisable at any time at the holder's election for the number of shares of common stock shown in column 3. |
 Remarks: Exhibit List: Exhibit 24.1 - Power of Attorney |