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 A Preferred Stock
|
Â
(1)
|
Â
(1)
|
Class A Common Stock
(2)
(3)
|
2,000,000
|
$
(1)
|
D
|
Â
|
Series A-1 Preferred Stock
|
Â
(1)
|
Â
(1)
|
Class A Common Stock
(2)
(3)
|
1,000,000
|
$
(1)
|
D
|
Â
|
Series B Preferred Stock
|
Â
(1)
|
Â
(1)
|
Class A Common Stock
(2)
(3)
|
495,495
|
$
(1)
|
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) |
Each share of Series A Preferred Stock, Series A-1 Preferred Stock, and Series B Preferred Stock will be automatically converted into one (1) share of Class A Common Stock immediately prior to the consummation of the Issuer's initial public offering of its Class B Common Stock ("IPO") and has no expiration date. |
(2) |
Each share of Class A Common Stock is convertible, at any time at the option of the holder, into one (1) share of Class B Common Stock. In addition, pursuant to the Issuer's Restated Certificate of Incorporation that will be effective upon the consummation of the IPO (the "Post-Effective Certificate"), each share of Class A Common Stock will convert automatically into one (1) share of Class B Common Stock upon a transfer of such share of Class A Common Stock, whether or not for value, that occurs after the closing of the IPO to any transferee who is not a "Permitted Transferee," as defined in the Post-Effective Certificate. The shares of Class A Common Stock and Class B Common Stock have no expiration date. |
(3) |
Pursuant to the Post-Effective Certificate, each share of Class A Common Stock will convert automatically into one (1) share of Class B Common Stock upon the earliest to occur of the following: (a) the first date on which the number of shares of Class A Common Stock then outstanding falls below twenty percent of the number of shares of Class A common stock outstanding as of the closing of the IPO, (b) the ten year anniversary of the closing of the IPO, or (c) a time and date approved in writing by holders of at least a majority of the then-outstanding shares of Class A Common Stock. |