SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Mario Family Credit LLC Series D

(Last) (First) (Middle)
P.O. BOX 445
20 FAIRMOUNT AVENUE

(Street)
CHATHAM NJ 07928

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Liquidia Technologies Inc [ LQDA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
07/30/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common stock 07/30/2018 C 107,791 A (1) 107,791 D(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Warrant to purchase Series D Preferred Stock $0.01 07/30/2018 J(2) 313,503 02/17/2017 12/31/2026 Series D Preferred Stock 313,503 (2) 0 D(3)
Warrant to purchase Common Stock $0.01 07/30/2018 J(2) 18,630 02/17/2017 12/31/2026 Common Stock 18,630 (2) 18,630 D(3)
Series D Preferred Stock (1) 07/30/2018 C 1,813,840 (1) (1) Common Stock 107,791 (1) 0 D(3)
1. Name and Address of Reporting Person*
Mario Family Credit LLC Series D

(Last) (First) (Middle)
P.O. BOX 445
20 FAIRMOUNT AVENUE

(Street)
CHATHAM NJ 07928

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Mario Jeremy

(Last) (First) (Middle)
P.O. BOX 445
20 FAIRMOUNT AVENUE

(Street)
CHATHAM NJ 07928

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Melmotte LLC

(Last) (First) (Middle)
P.O. BOX 445
20 FAIRMOUNT AVENUE

(Street)
CHATHAM NJ 07928

(City) (State) (Zip)
Explanation of Responses:
1. The Series D preferred stock had no expiration date and automatically converted into the Issuer's common stock on approximately a 0.0594-for-1 basis immediately prior to the closing of the Issuer's initial public offering.
2. Immediately prior to the closing of the Issuer's initial public offering and without payment of further consideration, the Warrants to purchase Series D Preferred Stock automatically became exercisable to purchase the Issuer's common stock. The transaction is listed solely for the purpose of reporting the change of the title and amount of securities underlying the warrant.
3. This report on Form 4 is jointly filed by Mario Family Credit LLC Series D, Melmotte LLC and Mr. Mario. Melmotte LLC is the manager of Mario Family Credit LLC Series D, and Mr. Mario is the managing member of Melmotte LLC. Each of the reporting persons disclaims beneficial ownership of the securities reported herein for purposes of Rule 16a-1(a) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), except to the extent of its or his pecuniary interest therein, if any. This report shall not be deemed an admission that any of the reporting persons is a beneficial owner of such securities for the purposes of Section 16 of the Exchange Act, or for any other purposes.
MARIO FAMILY CREDIT LLC SERIES D By: Melmotte LLC, its Manager By: Jeremy Mario, Managing Member of Melmotte LLC MELMOTTE LLC By: Jeremy Mario, Managing Member By: Jeremy Mario 08/01/2018
** Signature of Reporting Person Date
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* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
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