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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series E Preferred Stock | (1) | 11/15/2005 | C | 1,933,184 | (1) | (1) | Common Stock | 1,933,184 | $ 0 | 0 | I | See Footnote (2) | |||
Series F Preferred Stock | (1) | 11/15/2005 | C | 156,053 | (1) | (1) | Common Stock | 156,053 | $ 0 | 0 | I | See Footnote (2) | |||
Series E Preferred Stock | (1) | 11/15/2005 | C | 1,731,817 | (1) | (1) | Common Stock | 1,731,817 | $ 0 | 0 | I | See Footnote (3) | |||
SeriesF Preferred Stock | (1) | 11/15/2005 | C | 139,798 | (1) | (1) | Common Stock | 139,798 | $ 0 | 0 | I | See Footnote (3) | |||
Series E Preferred Stock | (1) | 11/15/2005 | C | 9,605 | (1) | (1) | Common Stock | 9,605 | $ 0 | 0 | I | See Footnote (4) | |||
Series F Preferred Stock | (1) | 11/15/2005 | C | 775 | (1) | (1) | Common Stock | 775 | $ 0 | 0 | I | See Footnote (4) | |||
Series E Preferred Stock | (1) | 11/15/2005 | C | 10,065 | (1) | (1) | Common Stock | 10,065 | $ 0 | 0 | I | See Footnote (5) | |||
Series F Preferred Stock | (1) | 11/15/2005 | C | 813 | (1) | (1) | Common Stock | 813 | $ 0 | 0 | I | See Footnote (5) | |||
Series E Preferred Stock | (1) | 11/15/2005 | C | 50,125 | (1) | (1) | Common Stock | 50,125 | $ 0 | 0 | I | See Footnote (6) | |||
Series F Preferred Stock | (1) | 11/15/2005 | C | 4,046 | (1) | (1) | Common Stock | 4,046 | $ 0 | 0 | I | See Footnote (6) | |||
Series E Preferred Stock | (1) | 11/15/2005 | C | 131,572 | (1) | (1) | Common Stock | 131,572 | $ 0 | 0 | I | See Footnote (7) | |||
Series F Preferred Stock | (1) | 11/15/2005 | C | 10,621 | (1) | (1) | Common Stock | 10,621 | $ 0 | 0 | I | See Footnote (7) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
TRIDENT CAPITAL MANAGEMENT V LLC C/O TRIDENT CAPITAL 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL FUND V AFFILIATES FUND LP C/O TRIDENT CAPITAL 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL FUND V PRINCIPALS FUND L P C/O TRIDENT CAPITAL 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL PARALLEL FUND V CV C/O TRIDENT CAPITAL 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL FUND V AFFILIATES FUND Q LP C/O TRIDENT CAPITAL 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL FUND V LP C/O TRIDENT CAPITAL 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 34301 |
X |
/s/ Bonnie N. Kennedy, Managing Director, Trident Capital Management V, L.L.C. | 11/15/2005 | |
**Signature of Reporting Person | Date | |
/s/ Bonnie N. Kennedy, Managing Director, Trident Capital Fund-V Affiliates Fund, L.P. | 11/15/2005 | |
**Signature of Reporting Person | Date | |
/s/ Bonnie N. Kennedy, Managing Director, Trident Capital Fund-V Principals Fund, L.P. | 11/15/2005 | |
**Signature of Reporting Person | Date | |
/s/ Bonnie N. Kennedy, Managing Director, Trident Capital Parallel Fund-V, C.V. | 11/15/2005 | |
**Signature of Reporting Person | Date | |
/s/ Bonnie N. Kennedy, Managing Director, Trident Capital Fund-V Affiliates Fund (Q), L.P. | 11/15/2005 | |
**Signature of Reporting Person | Date | |
/s/ Bonnie N. Kennedy, Managing Director, Trident Capital Fund-V, L.P. | 11/15/2005 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The preferred stock automatically converted upon the consummation of the Issuer's initial public offering on a one-for-one basis. |
(2) | Consists of shares held indirectly by Trident Capital Management-V, L.L.C. as sole general partner of Trident Capital Fund-V, L.P., Trident Capital Fund-V Affiliates Fund, L.P., Trident Capital Fund-V Affiliates Fund (Q), L.P., and Trident Capital Fund-V Principals Fund, L.P. and the sole investment general partner of Trident Capital Parallel Fund-V, C.V. The reporting person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest, if any, and this report shall not be deemed an admission that the reporting person is the beneficial owner of all of the reported shares for purposes of Section 16 or any other purpose. |
(3) | Consists of shares owned by Trident Capital Fund-V, L.P. |
(4) | Consists of shares owned by Trident Capital Fund-V Affiliates Fund (Q), L.P. |
(5) | Consists of shares owned by Trident Capital Fund-V Affiliates Fund, L.P. |
(6) | Consists of shares owned by Trident Capital Fund-V Principals Fund, L.P. |
(7) | Consists of shares owned by Trident Capital Parallel Fund-V, C.V. |
(8) | Shares sold pursuant to the exercise of the over-allotment option in connection with the intial public offering of common stock of iRobot Corporation. |