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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 B Preferred Stock | (1) | 11/18/2013 | C | 4,214,858 | (1) | (4) | Common Stock | 4,214,858 | (1) | 0 | D | ||||
Series C-1 Preferred Stock | (1) | 11/18/2013 | C | 3,132,962 | (1) | (4) | Common Stock | 3,132,962 | (1) | 0 | D | ||||
Series E Preferred Stock | (2) | 11/18/2013 | C | 507,665 | (2) | (4) | Common Stock | 507,665 | (2) | 0 | D | ||||
Series B Preferred Stock Warrant (right to buy) | $ 0.71 | 11/18/2013 | M(3) | 15,739 | (5) | 12/09/2013 | Common Stock | 15,739 | (5) | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MOOS LLC 505 MONTGOMERY STREET SAN FRANCISCO, CA 94111 |
X | |||
ZEEV OREN 505 MONTGOMERY STREET SAN FRANCISCO, CA 94111 |
X | |||
SASSON ORI 505 MONTGOMERY STREET SAN FRANCISCO, CA 94111 |
X | |||
SASSON I SHARAM 505 MONTGOMERY STREET SAN FRANCISCO, CA 94111 |
X | |||
GYANI MOHAN S 505 MONTGOMERY STREET SAN FRANCISCO, CA 94111 |
X |
MOOS LLC By: /s/ Oren Zeev, Partner | 11/20/2013 | |
**Signature of Reporting Person | Date | |
/s/ Oren Zeev | 11/20/2013 | |
**Signature of Reporting Person | Date | |
/s/ Ori Sasson by Dave Borders, Attorney-in-Fact | 11/20/2013 | |
**Signature of Reporting Person | Date | |
/s/ Sharam Sasson by Dave Borders, Attorney-in-Fact | 11/20/2013 | |
**Signature of Reporting Person | Date | |
/s/ Mohan Gyani by Dave Borders, Attorney-in-Fact | 11/20/2013 | |
**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) | Each share of Preferred Stock automatically converted into 0.666666667 shares of the Issuer's Common Stock at the closing of the Issuer's initial public offering of Common Stock for no additional consideration. |
(2) | Each share of Series E Preferred Stock automatically converted into 1.37886 shares of the Issuer's Common Stock at the closing of the Issuer's initial public offering of Common Stock for no additional consideration. |
(3) | Net exercise of a Series B Preferred Stock warrant, for no additional consideration. |
(4) | None. |
(5) | 9,596 shares of the Issuer's common stock were issued upon the net exercise of the reported warrant that would otherwise have expired at the closing of the Issuer's initial public offering of Common Stock, for no additional consideration. |
Remarks: Oren Zeev, Ori Sasson, Sharam Sasson and Mohan Gyani are the managing members of MOOS LLC and share voting and investment power over the shares. |