SEC Info - Kazam Joshua A - ‘5’ for 12/31/17 re: Capricor Therapeutics, Inc.

FORM 5

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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).

Form 3 Holdings Reported.

Form 4 Transactions Reported.

1. Name and Address of Reporting Person^*

Kazam Joshua A

(Last)

(First)

(Middle)

C/O CAPRICOR THERAPEUTICS, INC.

8840 WILSHIRE BLVD., 2ND FLOOR

(Street)

BEVERLY HILLS

90211

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
CAPRICOR THERAPEUTICS, INC. [ CAPR ]

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

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

3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/17

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 at end of Issuer's Fiscal Year (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
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)	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock	12/26/17		G ⁽¹⁾	1,000	D	$0	37,084	D
Common Stock	12/27/17		G ⁽¹⁾	17,786	D	$0	19,298	D
Common Stock							12,276	I	By Kazam Family Trust
Common Stock							3,310	I	By Spouse for Minor Child ⁽²⁾ ⁽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)
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)	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)

Explanation of Responses:

(1) Gift by the Reporting Person for estate planning purposes to an irrevocable blind grantor trust, which is managed by an independent trustee. The Reporting Person holds no voting or dispositive power over the securities held by the trust.

(2) Held by the Reporting Person's spouse as custodian for the benefit of their minor child under the Uniform Gift to Minors Act. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of these shares for purposes of Section 16 or any other purpose.

(3) The Reporting Person previously reported, in a Form 4 filed with the Securities and Exchange Commission on January 22, 2015, indirect beneficial ownership of 3,310 shares of Common Stock held by the Kash Family Foundation, of which the Reporting Person was at the time a co-trustee with the ability to vote and dispose of the shares. The Reporting Person had no pecuniary interest in the shares held by the Foundation. Subsequent to January 22, 2015, the Reporting Person ceased to serve as a co-trustee of the Foundation and accordingly the shares held by the Foundation are not reported in this Form 5.

	/s/ Linda Marban, as Attorney-in-Fact	2/14/18
	** 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.
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.

____________ Transaction Code:
G	Bona fide gift.

Kazam Joshua A – ‘5’ for 12/31/17 re: Capricor Therapeutics, Inc.

On: Wednesday, 2/14/18, at 5:16pm ET · For: 12/31/17 · Accession #: 1144204-18-9043 · File #: 1-34058

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Annual Statement of Changes in Beneficial Ownership of Securities by an Insider — Form 5 — SEA’34
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This ‘5’ Document is an XML Data File that may be rendered in various formats:

Kazam Joshua A – ‘5’ for 12/31/17 re: Capricor Therapeutics, Inc.

On: Wednesday, 2/14/18, at 5:16pm ET · For: 12/31/17 · Accession #: 1144204-18-9043 · File #: 1-34058

Previous ‘5’: ‘5’ on 2/14/17 for 12/31/16 · Next & Latest: ‘5’ on 2/3/21 for 12/31/20

Annual Statement of Changes in Beneficial Ownership of Securities by an Insider — Form 5 — SEA’34Filing Table of Contents

This ‘5’ Document is an XML Data File that may be rendered in various formats:

Annual Statement of Changes in Beneficial Ownership of Securities by an Insider — Form 5 — SEA’34
Filing Table of Contents