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 |
12% Convertible Notes
|
Â
(1)
|
Â
(1)
|
Units consisting of common stock and warrant
(2)
|
14,652
|
$
(1)
|
D
|
Â
|
Stock Option (right to buy)
|
Â
(3)
|
08/01/2018 |
Common Stock, $0.001 par value per share
|
1,915
|
$
8.23
|
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) |
The outstanding principal amount of the 12% Convertible Notes, and all accrued interest thereon, will automatically convert into units, each unit consisting of two
shares of common stock and a warrant to purchase one share of common stock, at a conversion price of $6.50 per unit, upon the consummation of the Company's
initial public offering. |
(2) |
Each unit consists of two shares of common stock and a warrant to purchase one share of common stock at an exercise price of $3.4375 per share. Each warrant will
become exercisable upon the earlier to occur of the expiration of the underwriters' over allotment option or its exercise in full (in connection with the Company's initial
public offering), and will expire on March 24, 2015, or earlier upon redemption. |
(3) |
These options vest as follows: 1/3 on March 4, 2009; an additional 1/3 on March 4, 2010; and the remaining 1/3 on March 4, 2011. |