|
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 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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) |
||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series B Convertible Preferred Stock | (1) | 02/09/2011 | C | 255,458 | (1) | (1) | Common Stock | 255,458 | (1) | 0 | I | By Sanderling Venture Partners V, L.P. (3) (4) | |||
Series C-1 Convertible Preferred Stock | (1) | 02/09/2011 | C | 255,458 | (1) | (1) | Common Stock | 255,458 | (1) | 0 | I | By Sanderling Venture Partners V, L.P. (3) (4) | |||
Series C-2 Convertible Preferred Stock | (1) | 02/09/2011 | C | 340,612 | (1) | (1) | Common Stock | 340,612 | (1) | 0 | I | By Sanderling Venture Partners V, L.P. (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 29,303 | (1) | (1) | Common Stock | 29,303 | (1) | 0 | I | By Sanderling Venture Partners V, L.P. (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 435,861 | (1) | (1) | Common Stock | 435,861 | (1) | 0 | I | By Sanderling Venture Partners VI Co-Investment Fund, L.P. (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 267,491 | (1) | (1) | Common Stock | 267,491 | (1) | 0 | I | By Sanderling Venture Partners V Co-Investment Fund, L.P. (3) (4) | |||
Series B Convertible Preferred Stock | (1) | 02/09/2011 | C | 62,574 | (1) | (1) | Common Stock | 62,574 | (1) | 0 | I | By Sanderling V Biomedical, L.P. (3) (4) | |||
Series C-1 Convertible Preferred Stock | (1) | 02/09/2011 | C | 62,573 | (1) | (1) | Common Stock | 62,573 | (1) | 0 | I | By Sanderling V Biomedical, L.P. (3) (4) | |||
Series C-2 Convertible Preferred Stock | (1) | 02/09/2011 | C | 83,431 | (1) | (1) | Common Stock | 83,431 | (1) | 0 | I | By Sanderling V Biomedical, L.P. (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 7,141 | (1) | (1) | Common Stock | 7,141 | (1) | 0 | I | By Sanderling V Biomedical, L.P. (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 162,170 | (1) | (1) | Common Stock | 162,170 | (1) | 0 | I | By Sanderling V Biomedical Co-Investment Fund, L.P. (3) (4) | |||
Series B Convertible Preferred Stock | (1) | 02/09/2011 | C | 25,316 | (1) | (1) | Common Stock | 25,316 | (1) | 0 | I | By Sanderling V Limited Partnership (3) (4) | |||
Series C-1 Convertible Preferred Stock | (1) | 02/09/2011 | C | 25,315 | (1) | (1) | Common Stock | 25,315 | (1) | 0 | I | By Sanderling V Limited Partnership (3) (4) | |||
Series C-2 Convertible Preferred Stock | (1) | 02/09/2011 | C | 33,755 | (1) | (1) | Common Stock | 33,755 | (1) | 0 | I | By Sanderling V Limited Partnership (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 15,405 | (1) | (1) | Common Stock | 15,405 | (1) | 0 | I | By Sanderling V Limited Partnership (3) (4) | |||
Series B Convertible Preferred Stock | (1) | 02/09/2011 | C | 3,695 | (1) | (1) | Common Stock | 3,695 | (1) | 0 | I | By Sanderling Ventures Management V (3) (8) | |||
Series C-1 Convertible Preferred Stock | (1) | 02/09/2011 | C | 3,695 | (1) | (1) | Common Stock | 3,695 | (1) | 0 | I | By Sanderling Ventures Management V (3) (8) | |||
Series C-2 Convertible Preferred Stock | (1) | 02/09/2011 | C | 4,927 | (1) | (1) | Common Stock | 4,927 | (1) | 0 | I | By Sanderling Ventures Management V (3) (8) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 5,001 | (1) | (1) | Common Stock | 5,001 | (1) | 0 | I | By Sanderling Ventures Management V (3) (8) | |||
Series B Convertible Preferred Stock | (1) | 02/09/2011 | C | 22,526 | (1) | (1) | Common Stock | 22,526 | (1) | 0 | I | By Sanderling V Beteiligungs GmbH & Co. KG (3) (4) | |||
Series C-1 Convertible Preferred Stock | (1) | 02/09/2011 | C | 22,526 | (1) | (1) | Common Stock | 22,526 | (1) | 0 | I | By Sanderling V Beteiligungs GmbH & Co. KG (3) (4) | |||
Series C-2 Convertible Preferred Stock | (1) | 02/09/2011 | C | 30,035 | (1) | (1) | Common Stock | 30,035 | (1) | 0 | I | By Sanderling V Beteiligungs GmbH & Co. KG (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 13,707 | (1) | (1) | Common Stock | 13,707 | (1) | 0 | I | By Sanderling V Beteiligungs GmbH & Co. KG (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 30,766 | (1) | (1) | Common Stock | 30,766 | (1) | 0 | I | By Sanderling Ventures Management VI (3) (8) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 10,049 | (1) | (1) | Common Stock | 10,049 | (1) | 0 | I | By Sanderling VI Limited Partnership (3) (4) | |||
Series C-3 Convertible Preferred Stock | (1) | 02/09/2011 | C | 8,434 | (1) | (1) | Common Stock | 8,434 | (1) | 0 | I | By Sanderling VI Beteiligungs GmbH & Co. KG (3) (4) | |||
Stock Option (right to buy) | $ 7.23 | 02/09/2011 | A | 15,706 | (10) | 02/09/2021 | Common Stock | 15,706 | $ 0 | 15,706 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MIDDLETON FRED A 400 S. EL CAMINO REAL, SUITE 1200 SAN MATEO, CA 94402 |
X |
/s/ Fred A. Middleton | 02/11/2011 | |
**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) | Each share of the Issuer's Series A-1, Series A-2, Series B, Series C-1, Series C-2 and Series C-3 Preferred Stock automatically converted into shares of Common Stock on a one-for-one basis upon the closing of the Issuer's initial public offering and has no expiration date. |
(2) | 72,502 shares held by Sanderling Venture Partners V, L.P. are subject to repurchase based on milestones set forth in the Restricted Stock Purchase Agreement dated July 10, 2001 between the Company and each of Sanderling Venture Partners V, L.P., Sanderling V Biomedical, L.P., ABV Holding Company 7 LLC, Douglas G. Bailey, and Cincinnati Financial Corporation. |
(3) | Mr. Middleton disclaims beneficial ownership of the shares directly held by the entities affiliated with Sanderling except to the extent of his individual pecuniary interest therein. |
(4) | Fred Middleton is a managing director of Middleton, McNeil & Mills Associates V, LLC which has the ultimate voting and investment power over shares held of record by Sanderling V Beteiligungs GmbH & Co. KG, Sanderling V Biomedical Co-Investment Fund, L.P., Sanderling V Biomedical, L.P., Sanderling V Limited Partnership, Sanderling Venture Partners V, L.P., Sanderling Venture Partners VI Co-Investment Fund, L.P., Sanderling VI Beteiligungs GmbH and Co. KG, Sanderling VI Limited Partnership and Sanderling V Strategic Exit Fund, L.P. and he may be deemed to have voting and investment power over shares held of record by Sanderling V Beteiligungs GmbH & Co. KG, Sanderling V Biomedical Co-Investment Fund, L.P., Sanderling V Biomedical, L.P., Sanderling V Limited Partnership, Sanderling Venture Partners V, L.P., Sanderling Venture Partners VI Co-Investment Fund, L.P., Sanderling VI Beteiligungs GmbH and Co. KG, Sanderling V Strategic Exit Fund, L.P. and Sanderling VI Limited Partnership. |
(5) | 17,759 shares held by Sanderling V Biomedical, L.P. are subject to repurchase based on milestones set forth in the Restricted Stock Purchase Agreement dated July 10, 2001 between the Company and each of Sanderling Venture Partners V, L.P., Sanderling V Biomedical, L.P., ABV Holding Company 7 LLC, Douglas G. Bailey, and Cincinnati Financial Corporation. |
(6) | 7,185 shares held by Sanderling V Limited Partnership are subject to repurchase based on milestones set forth in the Restricted Stock Purchase Agreement dated July 10, 2001 between the Company and each of Sanderling Venture Partners V, L.P., Sanderling V Biomedical, L.P., ABV Holding Company 7 LLC, Douglas G. Bailey, and Cincinnati Financial Corporation. |
(7) | 44,502 shares held by Sanderling Ventures Management V are subject to repurchase based on milestones set forth in the Restricted Stock Purchase Agreement dated July 10, 2001 between the Company and each of Sanderling Venture Partners V, L.P., Sanderling V Biomedical, L.P., ABV Holding Company 7 LLC, Douglas G. Bailey, and Cincinnati Financial Corporation. |
(8) | Fred Middleton is the owner of Sanderling Ventures Management V and Sanderling Ventures Management VI Partnership and he may be deemed to have voting and investment power over shares held of record by Sanderling Ventures Management V and Sanderling Ventures Management VI Partnership. |
(9) | 6,393 shares held by Sanderling V Beteiligungs GmbH & Co. KG are subject to repurchase based on milestones set forth in the Restricted Stock Purchase Agreement dated July 10, 2001 between the Company and each of Sanderling Venture Partners V, L.P., Sanderling V Biomedical, L.P., ABV Holding Company 7 LLC, Douglas G. Bailey, and Cincinnati Financial Corporation. |
(10) | Shares subject to the option vest 1/3 of the shares upon the business day before each of the Issuer's first three annual stockholder meetings following February 9, 2011. |