3: Initial statement of beneficial ownership of securities
Published on September 28, 2021
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 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 |
Reporting Owners
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Kavuru Vimal C/O ACASTI PHARMA INC. 3009 BOUL. DE LA CONCORDE EAST SUITE 102 LAVAL, A8 H7T 2B5 |
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Signatures
/s/ Jason Comerford, Attorney-in-Fact | 09/28/2021 | |
**Signature of Reporting Person | Date |
Explanation of Responses:
* | 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) | Shares are held directly by Shore Pharma LLC, of which Vimal Kavuru is the sole member. |
(2) | Shares are held directly by Kottayil Grace Pharma LLC, of which Vimal Kavuru is a Manager. Mr. Kavuru is a Manager of Kottayil Grace Pharma LLC and shares voting and dispositive power with respect to the shares of Acasti Pharma Inc. directly held by Kottayil Grace Pharma LLC. |
Remarks: Exhibit List - Exhibit 24 - Power of Attorney |