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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 C Preferred Stock | (1) | 08/13/2007 | C | 3,880,750 | (1) | (1) | Common Stock | 1,201,675 | $ 0 | 0 | I | By NCP-1, L.P. (3) | |||
Series E Preferred Stock | (2) | 08/13/2007 | C | 4,955,912 | (2) | (2) | Common Stock | 1,101,313 | $ 0 | 0 | I | By NCP-1, L.P. (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MOCK LAWRENCE E, JR. ONE BUCKHEAD PLAZA 3060 PEACHTREE ROAD, SUITE 780 ATLANTA, GA 30305 |
X | |||
MV-I GP, LLC ONE BUCKHEAD PLAZA 3060 PEACHTREE ROAD, SUITE 780 ATLANTA, GA 30305 |
X | |||
NAVIGATION CAPITAL PARTNERS III, L.P. ONE BUCKHEAD PLAZA 3060 PEACHTREE ROAD, SUITE 780 ATLANTA, GA 30305 |
X | |||
NCP GENERAL PARTNER III, LLC ONE BUCKHEAD PLAZA 3060 PEACHTREE ROAD, SUITE 780 ATLANTA, GA 30305 |
X | |||
NCP-1, L.P. 3060 PEACHTREE ROAD SUITE 780 ATLANTA, GA 30305 |
X | |||
RICHARDSON JOHN S. ONE BUCKHEAD PLAZA 3060 PEACHTREE ROAD, SUITE 780 ATLANTA, GA 30305 |
X |
/s/ Jason R. Wisniewski, as Attorney in Fact for Lawrence E. Mock, Jr. | 08/14/2007 | |
**Signature of Reporting Person | Date | |
/s/ Jason R. Wisniewski, as Attorney in Fact for MV-I GP, LLC | 08/14/2007 | |
**Signature of Reporting Person | Date | |
/s/ Jason R. Wisniewski, as Attorney in Fact for Navigation Capital Partners III, L.P. | 08/14/2007 | |
**Signature of Reporting Person | Date | |
/s/ Jason R. Wisniewski, as Attorney in Fact for NCP General Partner III, LLC | 08/14/2007 | |
**Signature of Reporting Person | Date | |
/s/ Jason R. Wisniewski, as Attorney in Fact for NCP-1, L.P. | 08/14/2007 | |
**Signature of Reporting Person | Date | |
/s/ Jason R. Wisniewski, as Attorney in Fact for John S. Richardson | 08/14/2007 | |
**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 Series C Preferred Stock converted into HireRight, Inc. common stock and has no expiration date. |
(2) | The Series E Preferred Stock converted into HireRight, Inc. common stock and has no expiration date. |
(3) | The reported securities are owned directly by NCP-1, L.P. The general partner of NCP-1, L.P. is MV-1 GP, LLC, whose sole member is Navigation Capital Partners III, L.P., whose general partner is NCP General Partner III, LLC. Messrs. John Richardson and Lawrence E. Mock, Jr. are the sole members and managers of NCP General Partner III, LLC. These other entities and individuals may be deemed to be indirect beneficial owners of the securities owned directly by NCP-1, L.P. Such other entities and individuals expressly disclaim such beneficial ownership, except to the extent of their pecuniary interest therein. |