Sec Form 13G Filing - Remeditex Ventures LLC filing for Apollo Endosurgery Inc. (APEN) - 2017-01-09

Insider filing report for Changes in Beneficial Ownership

  • Schedule 13G & 13D forms are used to report a party's ownership of stock which exceeds 5% of a company's total stock issue.
  • Schedule 13G is a shorter version of Schedule 13D with fewer reporting requirements.
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SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

SCHEDULE 13G

(Rule 13d-102)

Information to be Included in Statements filed Pursuant to

Rule 13d-1(b), (c) and (d) and Amendments Thereto Filed Pursuant to Rule 13d-2

(Amendment No.     )*

 

 

Apollo Endosurgery, Inc.

(Name of Issuer)

Common Stock

(Title of Class of Securities)

03767D 108

(CUSIP NUMBER)

 

 

December 29, 2016

(Date of Event which Requires Filing of this Statement)

 

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

☐ Rule 13d-1(b)

☒ Rule 13d-1(c)

☐ Rule 13d-1(d)

 

 

* The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.

The information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 

 

 


SCHEDULE 13G

 

Cusip No. 03767D 108   Page 2 of 8 Pages

 

  1.   

Name of Reporting Persons:

 

Remeditex Ventures LLC

  2.  

Check the appropriate box if a member of a group

(a)  ☐        (b)  ☒ (joint filers)

 

  3.  

SEC Use Only.

 

  4.  

Citizenship or Place of Organization

 

    Texas

Number of

Shares

Beneficially

Owned by

Each

Reporting

Person

With

   5.    

Sole Voting Power

 

    0

   6.   

Shared Voting Power

 

    1,309,392

   7.   

Sole Dispositive Power

 

    0

   8.   

Shared Dispositive Power

 

    1,309,392

  9.  

Aggregate amount beneficially owned by each reporting person

 

    1,309,392

10.  

Check box if the aggregate amount in row 9 excludes certain shares    ☐

 

11.  

Percent of class represented by amount in row 9

 

    12.2%

12.  

Type of Reporting Person

 

    OO

 


SCHEDULE 13G

 

Cusip No. 03767D 108   Page 3 of 8 Pages

 

  1.   

Name of Reporting Persons:

 

Malachite Trust

  2.  

Check the appropriate box if a member of a group

(a)  ☐        (b)  ☒ (joint filers)

 

  3.  

SEC Use Only.

 

  4.  

Citizenship or Place of Organization

 

    Texas

Number of

Shares

Beneficially

Owned by

Each

Reporting

Person

With

   5.    

Sole Voting Power

 

    0

   6.   

Shared Voting Power

 

    1,309,392

   7.   

Sole Dispositive Power

 

    0

   8.   

Shared Dispositive Power

 

    1,309,392

  9.  

Aggregate amount beneficially owned by each reporting person

 

    1,309,392

10.  

Check box if the aggregate amount in row 9 excludes certain shares    ☐

 

11.  

Percent of class represented by amount in row 9

 

    12.2%

12.  

Type of Reporting Person

 

    OO

 


SCHEDULE 13G

 

Cusip No. 03767D 108   Page 4 of 8 Pages

 

  1.   

Name of Reporting Persons:

 

Lyda Hill

  2.  

Check the appropriate box if a member of a group

(a)  ☐        (b)  ☒ (joint filers)

 

  3.  

SEC Use Only.

 

  4.  

Citizenship or Place of Organization

 

     United States

Number of

Shares

Beneficially

Owned by

Each

Reporting

Person

With

   5.    

Sole Voting Power

 

    0

   6.   

Shared Voting Power

 

    1,309,392

   7.   

Sole Dispositive Power

 

    0

   8.   

Shared Dispositive Power

 

    1,309,392

  9.  

Aggregate amount beneficially owned by each reporting person

 

    1,309,392

10.  

Check box if the aggregate amount in row 9 excludes certain shares    ☐

 

11.  

Percent of class represented by amount in row 9

 

    12.2%

12.  

Type of Reporting Person

 

    IN

 


Cusip No. 03767D 108   Page 5 of 8 Pages

 

SECURITIES AND EXCHANGE COMMISSION

SCHEDULE 13G

 

Item 1(a). Name of Issuer:

Apollo Endosurgery, Inc.

 

Item 1(b). Address of Issuer’s Principal Executive Offices:

1120 S. Capital of Texas Highway, Building 1, Suite #300, Austin, TX 78746

 

Item 2(a). Name of Person Filing:

This statement is filed on behalf of (1) Remeditex Ventures LLC, (2) Malachite Trust and (3) Lyda Hill.

 

Item 2(b). Address of Principal Business Office or, if none, Residence:

2727 N. Harwood St.

Suite 200

Dallas, Texas 75201

 

Item 2(c). Citizenship:

Remeditex Ventures LLC and Malachite Trust – Texas

Lyda Hill - United States of America.

 

Item 2(d). Title of Class of Securities:

Common Stock, $0.001 par value (the “Common Stock”)

 

Item 2(e). CUSIP Number.

The Issuer’s CUSIP Number is 03767D 108

 

Item 3. If this Statement is filed pursuant to Rule 13d-1(b), or 13d-2(b), or (c), check whether the person filing is a:

Not Applicable.

 

Item 4. Ownership.

 

  (a) Amount beneficially owned:

 

Remeditex Ventures LLC

     1,309,392   

Malachite Trust

     1,309,392   

Lyda Hill

     1,309,392   


Cusip No. 03767D 108   Page 6 of 8 Pages

 

Remeditex Ventures LLC is the record and beneficial owner of 1,3 09,392 shares of Common Stock and shares voting and dispositive power over such securities with Malachite Trust, the majority owner of Remeditex Ventures LLC and Lyda Hill. Ms. Hill is the Trustee of the Malachite Trust. By reason of such relationships, Ms. Hill, the Malachite Trust and Remeditex Ventures LLC may be deemed to share voting and dispositive power over 1,309,392 shares of Common Stock owned directly by Remeditex Ventures LLC. Remeditex Ventures LLC, the Malachite Trust and Lyda Hill each disclaims beneficial ownership of the reported securities except to the extent of its or her pecuniary interest therein.

 

  (b) Percent of Class:

 

Remeditex Ventures LLC

     12.2

Malachite Trust

     12.2

Lyda Hill

     12.2

The percentages used herein are calculated based on the 10,688,992 shares of Common Stock reported by Apollo Endosurgery, Inc. to be issued and outstanding as of December 29, 2016, in its Current Report on Form 8-K, as filed with the Securities and Exchange Commission on or about January 3, 2017.

 

  (c) Number of shares as to which such person has:

 

  (i) Sole power to vote or to direct the vote:

 

Remeditex Ventures LLC

     0   

Malachite Trust

     0   

Lyda Hill

     0   

 

  (ii) Shared power to vote or to direct the vote:

 

Remeditex Ventures LLC

     1,309,392   

Malachite Trust

     1,309,392   

Lyda Hill

     1,309,392   

 

  (iii) Sole power to dispose or to direct the disposition of:

 

Remeditex Ventures LLC

     0   

Malachite Trust

     0   

Lyda Hill

     0   

 

  (iv) Shared power to dispose or to direct the disposition of:

 

Remeditex Ventures LLC

     1,309,392   

Malachite Trust

     1,309,392   

Lyda Hill

     1,309,392   


Cusip No. 03767D 108   Page 7 of 8 Pages

 

Item 5. Ownership of Five Percent or Less of a Class.

Not Applicable.

 

Item 6. Ownership of More than Five Percent on Behalf of Another Person.

Not Applicable.

 

Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company.

Not Applicable.

 

Item 8. Identification and Classification of Members of the Group.

See Item 2(c), Item 4 and Exhibit 1.

 

Item 9. Notice of Dissolution of Group.

Not Applicable.

 

Item 10. Certification.

By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.

Exhibits:

Exhibit 1: Joint Filing Agreement, dated January 6, 2017, by and among Remeditex Ventures LLC, Malachite Trust and Lyda Hill.


Cusip No. 03767D 108   Page 8 of 8 Pages

 

SIGNATURES

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Dated: January 9, 2017

 

Remeditex Ventures LLC
By:  

/s/ Brett Ringle

  Brett Ringle, President
Malachite Trust
By:  

/s/ Lyda Hill

  Lyda Hill, Trustee

/s/ Lyda Hill

Lyda Hill