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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Sanderling Venture Partners V, LP 400 SOUTH EL CAMINO REAL SUITE 1200 SAN MATEO, CA 94402 |
X | |||
SANDERLING V BIOMEDICAL LP 400 SOUTH EL CAMINO REAL SUITE 1200 SAN MATEO, CA 94402 |
X | |||
SANDERLING V LTD PARTNERSHIP 400 SOUTH EL CAMINO REAL STE 1200 SAN MATEO, CA 94402-1708 |
X | |||
SANDERLING V BETEILIGUNGS GMBH & CO KG 400 SOUTH EL CAMINO REAL STE 1200 SAN MATEO, CA 94402-1708 |
X | |||
SANDERLING VENTURES MANAGEMENT V 400 SOUTH EL CAMINO REAL STE 1200 SAN MATEO, CA 94402-1708 |
X | |||
SANDERLING V BIOMEDICAL CO INVESTMENT FUND LP 400 S EL CAMINO REAL STE 1200 SAN MATEO, CA 94402-1708 |
X | |||
Sanderling Venture Partners V Co Investment Fund, LP 400 SOUTH EL CAMINO REAL SUITE 1200 SAN MATEO, CA 94402 |
X | |||
Sanderling V Strategic Exit Fund LP 400 S. EL CAMINO REAL SUITE 1200 SAN MATEO, CA 94402 |
X | |||
Sanderling Venture Partners VI Co Investment Fund LP 400 SOUTH EL CAMINO REAL STE 1200 SAN MATEO, CA 94402-1708 |
X | |||
Sanderling VI Beteiligungs GmbH & Co KG 400 S. EL CAMINO REAL, SUITE 1200 SAN MATEO, CA 94402 |
X |
See Signatures Included in Exhibit 99.2 | 05/28/2013 | |
**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) | Upon the closing of the Issuer's initial public offering, every 3.55 shares of Series F Preferred Stock automatically converted into 1 share of Common Stock for no additional consideration and had no expiration date. |
(2) | Amends the amount of securities beneficially owned following reported transactions which was understated by 112,674 shares in the original filing. |
(3) | See attached Exhibit 99.1 |
Remarks: Form 4 filing 1 of 2. See Form 4 filing 2 of 2 for additional members of this joint filing. |