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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series B Convertible Preferred Stock
|
Â
(2)
|
Â
(2)
|
Common Stock
|
70
|
$
(2)
|
D
|
Â
|
Special Voting Shares
|
Â
(3)
|
Â
(3)
|
Common Stock
|
1,025,559
|
$
(3)
|
D
|
Â
|
Stock Option (right to buy)
|
Â
(4)
|
12/04/2018 |
Common Stock
|
544,592
|
$
0.9
|
D
|
Â
|
Stock Option (right to buy)
|
Â
(5)
|
09/23/2021 |
Common Stock
|
309,679
|
$
1.04
|
D
|
Â
|
* |
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). |
(1) |
Represents unvested restricted stock subject to the issuer's right of repurchase as of the date of this filing, which repurchase right lapses over time. |
(2) |
Each share of the issuer's Series B Convertible Preferred Stock will be converted into 1 share of the issuer's Common Stock immediately upon the closing of the issuer's initial public offering ("IPO") and has no expiration date. |
(3) |
Each exchangeable share of Trupanion Canadian Shareholders, Ltd., a Canadian subsidiary of the issuer, will be automatically exchanged for 10 shares of the issuer's Common Stock immediately upon the closing of the issuer's IPO, which will trigger a mandatory redemption of each Special Voting Share, which Special Voting Share has no expiration date. |
(4) |
The option is fully vested. |
(5) |
The option vested as to 1/4 of the total shares on September 23, 2012, with an additional 1/48th of the total shares vesting monthly thereafter, subject to continued service through each vesting date. |