SEC FORM 3

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^*

PRESTRELSKI STEVEN

(Last)

(First)

(Middle)

C/O XERIS PHARMACEUTICALS, INC.

180 N. LASALLE STREET, SUITE 1810

(Street)

CHICAGO

60601

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
06/20/2018

3. Issuer Name and Ticker or Trading Symbol
XERIS PHARMACEUTICALS INC [ XERS ]

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

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
	Chief Scientific Officer

5. 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 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	451,961	D

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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Stock Option (Right to Buy)	⁽¹⁾	02/23/2022	Common Stock	11,228	$0.69	D
Stock Option (Right to Buy)	⁽¹⁾	12/26/2023	Common Stock	15,720	$1.19	D
Stock Option (Right to Buy)	⁽¹⁾	02/04/2027	Common Stock	28,072	$1.55	D
Stock Option (Right to Buy)	⁽¹⁾	06/12/2027	Common Stock	11,266	$1.55	D
Stock Option (Right to Buy)	⁽¹⁾	01/31/2028	Common Stock	14,036	$5.93	D
Series A Preferred Stock	⁽²⁾	⁽²⁾	Common Stock	30,233⁽³⁾	⁽²⁾	D
Series B Preferred Stock	⁽²⁾	⁽²⁾	Common Stock	7,130⁽⁴⁾	⁽²⁾	D

Explanation of Responses:

1. 25% of these shares shall vest on the first anniversary of the vesting commencement date, with the remainder vesting ratably over the following 36 months.

2. Each share of preferred stock is convertible on a 1.78112-for-1 basis into Common Stock at any time at the election of the Reporting Person and will automatically convert upon the closing of the Issuer's initial public offering into the number of shares of the Issuer's Common Stock shown in column 3 without payment or further consideration. The shares have no expiration date.

3. 13,760 of these shares are held by Steven Prestrelski , and 16,473 of these shares are held by Steven Prestrelski and Tracy Yeo.

4. These shares are held by Steven Prestrelski and Tracy Yeo.

Remarks:

Exhibit 24 - Power of Attorney

	/s/ Barry Deutsch, as Attorney-in-Fact	06/20/2018
	** 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 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.