SEC FORM
3
SEC Form 3
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL 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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 07/16/2020
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3. Issuer Name and Ticker or Trading Symbol
ALX ONCOLOGY HOLDINGS INC
[ ALXO ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
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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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
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: 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 |
Expiration Date |
Title |
Amount or Number of Shares |
Series A Convertible Preferred Stock |
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Common Stock |
1,633,743 |
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I |
See footnote
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Series A Convertible Preferred Stock |
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Common Stock |
222,752 |
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I |
See footnote
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Series A Convertible Preferred Stock |
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Common Stock |
683,523 |
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I |
See footnote
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Series A Convertible Preferred Stock |
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Common Stock |
39,758 |
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I |
See footnote
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Series B Convertible Preferred Stock |
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Common Stock |
59,998 |
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I |
See footnote
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Series B Convertible Preferred Stock |
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Common Stock |
8,175 |
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I |
See footnote
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Series B Convertible Preferred Stock |
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Common Stock |
150,801 |
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I |
See footnote
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Series B Convertible Preferred Stock |
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Common Stock |
11,110 |
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I |
See footnote
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Series C Convertible Preferred Stock |
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Common Stock |
137,286 |
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I |
See footnote
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Series C Convertible Preferred Stock |
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Common Stock |
18,705 |
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I |
See footnote
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Series C Convertible Preferred Stock |
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Common Stock |
664,660 |
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I |
See footnote
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Series C Convertible Preferred Stock |
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Common Stock |
38,660 |
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I |
See footnote
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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1. Name and Address of Reporting Person*
C/O LSV CAPITAL MANAGEMENT, LLC |
2884 SAND HILL ROAD, SUITE 121 |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Travis Boettner, by power of attorney for LSV Associates, LLC, the General Partner of Lightstone Ventures, L.P. |
07/16/2020 |
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/s/ Travis Boettner, by power of attorney for LSV Associates, LLC, the General Partner of Lightstone Ventures(A), L.P. |
07/16/2020 |
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/s/ Travis Boettner, by power of attorney for LSV Associates, LLC |
07/16/2020 |
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/s/ Travis Boettner, by power of attorney for LSV Associates II, LLC, the General Partner of Lightstone Ventures II, L.P. |
07/16/2020 |
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/s/ Travis Boettner, by power of attorney for LSV Associates II, LLC, the General Partner of Lightstone Ventures II(A), L.P. |
07/16/2020 |
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/s/ Travis Boettner, by power of attorney for LSV Associates II, LLC |
07/16/2020 |
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/s/ Travis Boettner, by power of attorney for Michael A. Carusi |
07/16/2020 |
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/s/ Travis Boettner, by power of attorney for Jean M. George |
07/16/2020 |
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/s/ Travis Boettner, by power of attorney for Henry A. Plain, Jr. |
07/16/2020 |
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** Signature of Reporting Person |
Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* 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). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
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 Number. |
Exhibit 24
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and
appoints Travis Boettner, the undersigned's true and lawful attorney-in-fact and
agent to:
(i) prepare, execute and file, for and on behalf of the undersigned, any
and all documents and filings that are required or advisable to be made
with the United States Securities and Exchange Commission, any stock
exchange or similar authority, under the Securities Exchange Act of 1934,
as amended (the "Exchange Act"), and the rules and regulations promulgated
thereunder, including without limitation (a) any Joint Filing Agreement
under Rule 13d-1(k) of the Exchange Act (or any successor provision
thereunder), Schedule 13D and Schedule 13G (or any successor schedules or
forms adopted under the Exchange Act) and any amendments thereto in
accordance with Section 13 of the Exchange Act and the rules thereunder,
and (b) Forms 3, 4 and 5 and any amendments thereto in accordance with
Section 16(a) of the Exchange Act and the rules thereunder; and
(i) take any other action of any nature whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of
benefit, in the best interest of, or legally required by, the undersigned,
it being understood that the documents executed by such attorney-in-fact
on behalf of the undersigned pursuant to this Power of Attorney shall be in
such form and shall contain such terms and conditions as such
attorney-in-fact may approve in such attorney-in-fact's discretion.
The undersigned hereby grants to such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing attorney-in-fact, in
serving in such capacity at the request of the undersigned, is not assuming any
of the undersigned's responsibilities to comply with the Exchange Act, including
without limitation Sections 13 and 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until the
earliest to occur of (a) the undersigned is no longer required to file any form
or document with respect to the undersigned's holdings of and transactions in
securities issued by a company, (b) revocation by the undersigned in a signed
writing delivered to the foregoing attorney-in-fact or (c) until such attorney-
in-fact's resignation or the termination of such attorney-in-fact's position as
Chief Financial Officer of LSV Capital Management, LLC.
IN WITNESS WHEREOF, the undersigned has cause this Power of Attorney to be
executed as of July 16, 2020.
Lightstone Ventures, L.P. Lightstone Ventures II, L.P.
By: LSV Associates, LLC By: LSV Associates II, LLC
Its: General Partner Its: General Partner
By: /s/ Michael A. Carusi By: /s/ Michael A. Carusi
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Name: Michael A. Carusi Name: Michael A. Carusi
Title: Managing Director Title: Managing Director
Lightstone Ventures (A), L.P. Lightstone Ventures II (A), L.P.
By: LSV Associates, LLC By: LSV Associates II, LLC
Its: General Partner Its: General Partner
By: /s/ Michael A. Carusi By: /s/ Michael A. Carusi
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Name: Michael A. Carusi Name: Michael A. Carusi
Title: Managing Director Title: Managing Director
LSV Associates, LLC LSV Associates II, LLC
By: /s/ Michael A. Carusi By: /s/ Michael A. Carusi
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Name: Michael A. Carusi Name: Michael A. Carusi
Title: Managing Director Title: Managing Director
By: /s/ Michael A. Carusi By : /s/ Jean M. George
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Name: Michael A. Carusi Name: Jean M. George
By: /s/ Henry A. Plain, Jr.
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Name: Henry A. Plain, Jr.