SEC FORM 3/A 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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1. Name and Address of Reporting Person*
Krishnan Krish S

(Last) (First) (Middle)
C/O KRYSTAL BIOTECH, INC.
2100 WHARTON STREET, SUITE 701

(Street)
PITTSBURGH PA 15203

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/19/2017
3. Issuer Name and Ticker or Trading Symbol
Krystal Biotech, Inc. [ KRYS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
President and CEO
5. If Amendment, Date of Original Filed (Month/Day/Year)
09/19/2017
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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: 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
Series A Convertible Preferred Stock(1) (1) (1) Common Stock 112,162(2) (1) I By trust(3)
Explanation of Responses:
1. The Series A convertible preferred stock will automatically convert on a one-to-one basis into 112,162 shares of common stock upon the closing of Krystal Biotech, Inc.'s initial public offering.
2. These shares were incorrectly included in the Non-Derivative Securities table in the reporting person's original Form 3, filed September 19, 2017.
3. The Krishnan Family Trust beneficially owns 112,162 shares of Series A convertible preferred stock. The reporting person and his spouse are each joint beneficial owners of the trust with joint voting and investment control.
Remarks:
/s/ Katherine A. Shaia,as attorney-in-fact for Krish S. Krishnan 09/25/2017
** 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).
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