# EDGAR Filing Document

**Accession Number:** 0001960552
**File Stem:** 0001753926-23-000020
**Filing Date:** 2023-1
**Character Count:** 4837
**Document Hash:** b2505fa71a2cf0f2769693951e8eba59
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001753926-23-000020.hdr.sgml**: 20230103

**ACCESSION NUMBER**: 0001753926-23-000020

**CONFORMED SUBMISSION TYPE**: 3

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20221219

**FILED AS OF DATE**: 20230103

**DATE AS OF CHANGE**: 20230103

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Yoshimura Naoki
- **CENTRAL INDEX KEY:** 0001960552

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41575
- **FILM NUMBER:** 23503990

**MAIL ADDRESS:**
- **STREET 1:** C/O LIPELLA PHARMACEUTICALS INC.
- **STREET 2:** 7800 SUSQUEHANNA ST., SUITE 505
- **CITY:** PITTSBURGH
- **STATE:** PA
- **ZIP:** 15208
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** LIPELLA PHARMACEUTICALS INC
- **CENTRAL INDEX KEY:** 0001347242
- **STANDARD INDUSTRIAL CLASSIFICATION:** PHARMACEUTICAL PREPARATIONS [2834]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 400 N LEXINGTON ST
- **STREET 2:** STE LL103
- **CITY:** PITTSBURGH
- **STATE:** PA
- **ZIP:** 15208
- **BUSINESS PHONE:** 412-901-0315

**MAIL ADDRESS:**
- **STREET 1:** 400 N LEXINGTON ST
- **STREET 2:** STE LL103
- **CITY:** PITTSBURGH
- **STATE:** PA
- **ZIP:** 15208

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

## FORM 3

### INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

[ ] 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**<sup>*</sup><br>Yoshimura Naoki<br><sub>(Last) (First) (Middle)</sub><br>C/O LIPELLA PHARMACEUTICALS INC.<br>7800 SUSQUEHANNA ST., SUITE 505<br><sub>(Street)</sub><br>PITTSBURGH, PA 15208<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>LIPELLA PHARMACEUTICALS INC [ LIPO ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2022-12-19 | **4. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director   [ ] 10% Owner<br>[ ] Officer (give title below)   [ ] Other (specify below)<br>_ _ | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities Beneficially Owned

---

|  |  |  |  |
| --- | --- | --- | --- |
| 1. Title of Security | 2. Amount of Securities Beneficially Owned | 3. Ownership Form | 4. Nature of Indirect Beneficial Ownership |

---

## Table II - Derivative Securities Beneficially Owned

---

|  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Underlying Securities | 3. Title and Amount of Underlying Securities | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| Stock Options | 2015-10-14 | 2025-10-14 | Common Stock | 4000<sup>(1)</sup> | $1.25 | D |  |
| Stock Options | 2021-09-03 | 2031-09-03 | Common Stock | 10000<sup>(2)</sup> | $5.00 | D |  |

---

### Footnotes:

(1) Number of shares of Common Stock beneficially owned consists of 4,000 shares of Common Stock issuable upon the exercise of stock options held by the Reporting Person, which are exercisable for shares of Common Stock at a price of $1.25 per share.

(2) Number of shares of Common Stock beneficially owned consists of 10,000 shares of Common Stock issuable upon the exercise of stock options held by the Reporting Person, which are exercisable for shares of Common Stock at a price of $5.00 per share.

**Signature:** /s/ Naoki Yoshimura  
**Date:** 2023-01-03

### Remarks:

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.**