Evoke Pharma
Evoke Pharma Inc (Form: 3, Received: 02/24/2017 20:55:00)
FORM 3
        
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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
                      

1. Name and Address of Reporting Person *

LVP GP III, LLC

2. Date of Event Requiring Statement (MM/DD/YYYY)
2/22/2017 

3. Issuer Name and Ticker or Trading Symbol

Evoke Pharma Inc [EVOK]

(Last)        (First)        (Middle)

2603 CAMINO RAMON, SUITE 200

4. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director                            ___ X ___ 10% Owner
_____ Officer (give title below)          _____ Other (specify below)

(Street)

SAN RAMON, CA 94583-4289       

(City)              (State)              (Zip)
5. If Amendment, Date Original Filed (MM/DD/YYYY)

 

6. Individual or Joint/Group Filing (Check Applicable Line)

___ Form filed by One Reporting Person
_ X _ Form filed by More than One Reporting Person


Table I - Non-Derivative Securities Beneficially Owned
1.Title of Security
(Instr. 4)
2. Amount of Securities Beneficially Owned
(Instr. 4)
3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
4. Nature of Indirect Beneficial Ownership
(Instr. 5)
Common Stock   1472867   I   Directly owned by LVP III   (1) (2)
Common Stock   73641   I   Directly owned by Associates   (1) (2)
Common Stock   36821   I   Directly owned by Partners   (1) (2)
Common Stock   5250   I   Directly owned by LVPMC   (1) (2)

Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 4)
2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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)
Date Exercisable Expiration Date Title Amount or Number of Shares

Explanation of Responses:
( 1)  The reported securities are owned directly by each of LVPMC, LLC ("LVPMC"), LVP Life Science Ventures III, L.P. ("LVP III"), LVP III Associates, L.P. ("Associates") and LVP III Partners, L.P. ("Partners"). LVP GP III, LLC ("GP III") is the general partner of LVP III, Associates and Partners. (Continued on Footnote 2.)
( 2)  GP III may be deemed to have sole voting power and dispositive power over the shares held by LVP III, Associates and Partners. Each of GP III and Patrick Latterell, the managing member of GP III and the manager of LVPMC, may be deemed to share voting and dispositive power over the reported securities and disclaim beneficial ownership of the reported securities held by LVPMC, LVP III, Associates and Partners except to the extent of any pecuniary interest therein.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
LVP GP III, LLC
2603 CAMINO RAMON
SUITE 200
SAN RAMON, CA 94583-4289

X

LVP III Associates, L.P.
2603 CAMINO RAMON
SUITE 200
SAN RAMON, CA 94583-4289

X

LVP III Partners LP
2603 CAMINO RAMON
SUITE 200
SAN RAMON, CA 94583-4289

X

LVP LIFE SCIENCE VENTURES III L.P.
2603 CAMINO RAMON
SUITE 200
SAN RAMON, CA 94583-4289

X

LVPMC, LLC
2603 CAMINO RAMON
SUITE 200
SAN RAMON, CA 94583-4289

X

LATTERELL PATRICK F
2603 CAMINO RAMON
SUITE 200
SAN RAMON, CA 94583-4289

X


Signatures
Patrick F. Latterell, Managing Member of LVP GP III, LLC 2/24/2017
** Signature of Reporting Person Date

Patrick F. Latterell, Managing Member of LVP GP III, LLC, General Partner of LVP III Associates, L.P. 2/24/2017
** Signature of Reporting Person Date

Patrick F. Latterell, Managing Member of LVP GP III, LLC, General Partner of LVP III Partners, L.P. 2/24/2017
** Signature of Reporting Person Date

Patrick F. Latterell, Managing Member of LVP GP III, LLC, General Partner of LVP Life Science Ventures III, L.P. 2/24/2017
** Signature of Reporting Person Date

Patrick F. Latterell, Manager of LVPMC, LLC 2/24/2017
** Signature of Reporting Person Date

Patrick F. Latterell, Manager of LVPMC, LLC and Managing Member of LVP GP III, LLC, the General Partner of LVP Life Science Ventures III, L.P., LVP III Associates, L.P. and LVP III Partners, L.P. 2/24/2017
** 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.
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