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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 | (2) | 11/19/2013 | C | 1,113,545 (3) | (2) | (2) | Common Stock | 664,565 (2) | $ 0 | 0 | I | Directly owned by Delphi Ventures VIII, L.P. (1) | |||
Series C Preferred Stock | (2) | 11/19/2013 | C | 10,871 (3) | (2) | (2) | Common Stock | 6,488 (2) | $ 0 | 0 | I | Directly owned by Delphi BioInvestments VIII, L.P. (1) | |||
Series D Preferred Stock | (2) | 11/19/2013 | C | 4,973,160 | (2) | (2) | Common Stock | 2,967,987 (2) | $ 0 | 0 | I | Directly owned by Delphi Ventures VIII, L.P. (1) | |||
Series D Preferred Stock | (2) | 11/19/2013 | C | 48,558 | (2) | (2) | Common Stock | 28,979 (2) | $ 0 | 0 | I | Directly owned by Delphi BioInvestments VIII, L.P. (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Delphi Management Partners VIII, L.L.C. 3000 SAND HILL ROAD, BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X | |||
DELPHI VENTURES VIII LP 3000 SAND HILL ROAD BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X | |||
Delphi BioInvestments VIII LP 3000 SAND HILL ROAD BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X | |||
PAKIANATHAN DEEPIKA 3000 SAND HILL ROAD BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X | |||
ROEDER DOUGLAS A C/O DELPHI VENTURES, 3000 SAND HILL RD., BLDG. 1, STE. 135 MENLO PARK, CA 94025 |
X | X | ||
DOUGLASS DAVID L 3000 SAND HILL ROAD BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X | |||
BOCHNOWSKI JAMES J 3000 SAND HILL ROAD BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X |
/s/ Matthew T. Potter, by power of attorney for Delphi Management Partners VIII, L.L.C. | 11/21/2013 | |
**Signature of Reporting Person | Date | |
/s/ Matthew T. Potter, by power of attorney for Delphi Management Partners VIII, L.L.C., as general partner of Delphi Ventures VIII, L.P. | 11/21/2013 | |
**Signature of Reporting Person | Date | |
/s/ Matthew T. Potter, by power of attorney for Delphi Management Partners VIII, L.L.C., as general partner of Delphi BioInvestments VIII, L.P. | 11/21/2013 | |
**Signature of Reporting Person | Date | |
/s/ Matthew T. Potter, by power of attorney for Deepika R. Pakianathan | 11/21/2013 | |
**Signature of Reporting Person | Date | |
/s/ Matthew T. Potter, by power of attorney for Douglas A. Roeder | 11/21/2013 | |
**Signature of Reporting Person | Date | |
/s/ Matthew T. Potter, by power of attorney for David L. Douglass | 11/21/2013 | |
**Signature of Reporting Person | Date | |
/s/ Matthew T. Potter, by power of attorney for James J. Bochnowski | 11/21/2013 | |
**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) | Delphi Management Partners VIII, L.L.C. ("DMP"), the general partner of each of Delphi Ventures VIII, L.P. and Delphi BioInvestments VIII, L.P. (collectivley, the "Delphi Funds"), may be deemed to have the sole voting and dispositive power over the reported securities. DMP and each of its managing members disclaim beneficial ownership in the securities held by the Delphi Funds except to the extent of any pecuniary interest therein, and the filing of this report is not an admission that DMP and each of its managing members is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. |
(2) | Each share of Preferred Stock automatically converted on a 1-to-0.5968 basis into Common Stock immediately upon the consummation of the Issuer's initial public offering and had no expiration date. |
(3) | The number of shares of Preferred Stock reflects the effect of applicable anti-dilution adjustments that occurred as a result of the issuance of the Series D Preferred Stock. |
Remarks: James J. Bochnowski, David L. Douglass, Deepika R. Pakianathan and Douglas A. Roeder are the managing members of DMP, which serves as the general partner to each of the Delphi Funds. Each reporting person disclaims the existence of a "group" and disclaims beneficial ownership of any securities except to the extent of such reporting person's pecuniary interest in such securities. |