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*
Heberlig Chris

(Last) (First) (Middle)
C/O KINIKSA PHARMACEUTICALS, LTD.
CLARENDON HOUSE 2 CHURCH STREET

(Street)
HAMILTON D0 HM11

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Kiniksa Pharmaceuticals, Ltd. [ KNSA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Exec VP & CFO
3. Date of Earliest Transaction (Month/Day/Year)
05/29/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
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 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
Class A Common Shares 05/29/2018 C 6,392 A $0.00 42,991 D
Class A Common Shares 36,598 I By Sandra C. Heberlig as trustee for the Christopher J. Heberlig 2017 Irrevocable Trust
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 C Preferred Shares (1) 02/09/2018 P 6,392(2) (1) (1) Class A Common Shares 6,392(2) $15.6438(2) 6,392(2) D
Series A Preferred Shares (3) 05/29/2018 C 74,935 (3) (3) Class B Common Shares 74,935 $0.00 0 D
Series C Preferred Shares (1) 05/29/2018 C 6,392 (1) (1) Class A Common Shares 6,392 $0.00 0 D
Class B Common Shares (4) 05/29/2018 C 74,935 (4) (4) Class A Common Shares 74,935 $0.00 440,920 D
Explanation of Responses:
1. Upon closing of the Issuer's initial public offering, the preferred shares automatically converted into the Issuer's Class A Common Shares on a one-for-one basis.
2. Reflects the 1-for-2.73235 share consolidation effected May 11, 2018.
3. Upon closing of the Issuer's initial public offering, the preferred shares automatically converted into the Issuer's Class B Common Shares on a one-for-one basis.
4. Each share of Class B Common Shares is convertible at any time at the election of the holder into one share of Class A Common Shares or one share of Class B1 Common Shares and will automatically convert into Class A Common Shares upon transfer to an unaffiliated party.
/s/ Thomas W. Beetham, Attorney-in-Fact for Chris Heberlig 05/29/2018
** 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).
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