Initial Statement of Beneficial Ownership (3)
30 Oktober 2015 - 11:07AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
CRYSTAL ROGER
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2. Date of Event Requiring Statement (MM/DD/YYYY)
12/10/2014
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3. Issuer Name
and
Ticker or Trading Symbol
Lightlake Therapeutics Inc. [LLTP]
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(Last)
(First)
(Middle)
445 PARK AVENUE, 9TH FLOOR
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__
X
__ Director
___
X
___ 10% Owner
___
X
___ Officer (give title below)
_____ Other (specify below)
Chief Executive Officer /
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(Street)
NEW YORK, NY 10022
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock par value $0.001
(1)
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5000
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Option
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12/31/2012
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12/30/2022
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Common Stock
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25000
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$12.00
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D
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Option
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12/31/2012
(2)
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12/30/2017
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Common Stock
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85000
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$15.00
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D
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Warrant
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12/31/2012
(2)
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12/30/2017
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Common Stock
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40000
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$15.00
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D
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Option
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12/31/2013
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12/30/2023
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Common Stock
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75000
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$6.00
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D
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Option
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5/1/2013
(3)
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12/30/2023
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Common Stock
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200000
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$8.00
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D
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Option
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5/1/2013
(4)
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12/30/2023
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Common Stock
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175000
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$10.00
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D
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Option
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8/1/2013
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7/31/2023
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Common Stock
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50000
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$15.00
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D
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Option
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8/1/2013
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7/31/2023
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Common Stock
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50000
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$20.00
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D
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Option
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6/15/2014
(5)
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6/14/2024
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Common Stock
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150000
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$5.00
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D
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Option
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6/15/2014
(5)
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6/14/2024
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Common Stock
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200000
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$8.00
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D
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Option
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10/27/2015
(6)
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10/26/2025
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Common Stock
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500000
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$7.25
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D
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Explanation of Responses:
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(
1)
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This Form 3 is a late filing reporting the beneficial ownership of the Reporting Person as of 12/10/2014, the effective date of the Issuer's Form 8-A registration statement which registered the common stock of the Issuer for the first time under Section 12 of the Exchange Act. In December 2014, the Issuer effected a one-for-one hundred reverse stock split of its common stock (the "1:100 Reverse Stock Split"). Unless otherwise noted, all share amounts and exercise prices listed in this Form 3 been retroactively adjusted for the 1:100 Reverse Stock Split as if such stock splits occurred prior to the issuance of such shares, warrants, or options.
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(
2)
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These options and this warrant may only be exercised between the following dates: (i) the date on which the Company's price per share has traded at or above US$0.30 (set prior to the 1:100 Reverse Stock Split) for at least three (3) trading days out of any ten (10) consecutive trading days; and (ii) five years from the grant date.
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(
3)
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50,000 vested on 5/1/2013, 50,000 vested on 11/1/2013, and 100,000 vested on 12/31/2013. All expire 10 years after their respective vesting dates.
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(
4)
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25,000 vested on 5/1/2013, 25,000 vested on 8/1/2013; 25,000 vested on 11/1/13, and 100,000 vested on 12/31/13. All expire 10 years after their respective vesting dates.
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(
5)
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These options may only be exercised between the following dates: (i) the first to occur of: (A) the commencement of the next trial with respect to the opioid overdose reversal treatment; (B) the entrance into a distribution, licensing, royalty, partnership, collaboration, or other significant transaction with respect to the opioid overdose reversal treatment; or (C) the filing of a New Drug Application with the U.S. Food and Drug Administration with respect to the opioid overdose reversal treatment; and (ii) the Expiration Date.
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(
6)
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These options may only be exercised between the following dates: (i) the first to occur of: (A) the commencement of three trials on or subsequent to October 23, 2015; or (B) (1) the approval by the U.S. Food and Drug Administration of the New Drug Application with respect to the opioid overdose reversal treatment; and (2) the commencement of two trials on or subsequent to October 23, 2015; and (ii) the Expiration Date.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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CRYSTAL ROGER
445 PARK AVENUE, 9TH FLOOR
NEW YORK, NY 10022
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X
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X
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Chief Executive Officer
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Signatures
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/s/ Dr. Roger Crystal
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10/29/2015
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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