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*
Palmetto Partners, Ltd.

(Last) (First) (Middle)
109 N. POST OAK LANE, SUITE 600

(Street)
HOUSTON TX 77024

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
XERIS PHARMACEUTICALS INC [ XERS ]
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)
06/25/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
06/25/2018
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
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
Series B Preferred Stock(1)(5) (2) 06/25/2018 C 1,657,125 (2) (2) Common Stock 930,383 (2) 0 D
Series C Preferred Stock(3)(5) (2) 06/25/2018 C 1,036,599 (2) (2) Common Stock 581,992 (2) 0 D
Series C Preferred Stock(4)(5) (2) 06/25/2018 C 797,384 (2) (2) Common Stock 447,686 (2) 0 D
1. Name and Address of Reporting Person*
Palmetto Partners, Ltd.

(Last) (First) (Middle)
109 N. POST OAK LANE, SUITE 600

(Street)
HOUSTON TX 77024

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Palmetto Partners 2014, LP

(Last) (First) (Middle)
109 N. POST OAK LANE, SUITE 600

(Street)
HOUSTON TX 77024

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Palmetto Partners 2015, LP

(Last) (First) (Middle)
109 N. POST OAK LANE, SUITE 600

(Street)
HOUSTON TX 77024

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The securities are owned by Palmetto Partners 2014, LP, who is a member of a group with Palmetto Partners, Ltd. and Palmetto Partners 2015, LP.
2. Each share of Preferred Stock automatically converted into Common Stock, for no additional payment or consideration, on a 1.78112-for-1 basis, at the closing of the Issuer's initial public offering on June 25, 2018 and had no expiration date.
3. The securities are owned by Palmetto Partners 2015, LP, who is a member of a group with Palmetto Partners, Ltd. and Palmetto Partners 2014, LP.
4. The securities are owned by Palmetto Partners, Ltd., who is a member of a group with Palmetto Partners 2014, LP and Palmetto Partners 2015, LP.
5. This Form 4/A is being filed to correct the title of the derivative securities held by the Reporting Persons.
Remarks:
Palmetto Partners, Ltd., by /s/ Ben D. Smolij, attorney in fact 06/28/2018
Palmetto Partners 2014, LP, by /s/ Ben D. Smolij, attorney in fact 06/28/2018
Palmetto Partners 2015, LP, by /s/ Ben D. Smolij, attorney in fact 06/28/2018
** 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 4 (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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