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 |
Nonqualified Stock Option (Right to Buy)
|
Â
(1)
|
05/05/2013 |
Common Stock
|
149,074
(5)
|
$
0.33
(6)
|
D
|
Â
|
Nonqualified Stock Option (Right to Buy)
|
Â
(2)
|
02/10/2015 |
Common Stock
|
128,408
(5)
|
$
0.33
(6)
|
D
|
Â
|
Nonqualified Stock Option (Right to Buy)
|
Â
(3)
|
09/28/2015 |
Common Stock
|
413,620
(5)
|
$
0.33
(6)
|
D
|
Â
|
Nonqualified Stock Option (Right to Buy)
|
Â
(4)
|
12/19/2015 |
Common Stock
|
190,373
(5)
|
$
4.73
(6)
|
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) |
Exercisable with respect to 108,699 of the shares immediately. Exercisable with respect to an additional 2.08333% of the aggregate option share total each month thereafter. |
(2) |
Exercisable with respect to 37,452 of the shares immediately. Exercisable with respect to an additional 2.08333% of the aggregate option share total each month thereafter. |
(3) |
Exercisable with respect to 25% of the shares on 09/28/06. Exercisable with respect to an additional 2.08333% of the aggregate option share total each month thereafter. |
(4) |
Exercisable with respect to 25% of the shares on 12/29/06. Exercisable with respect to an additional 2.08333% of the aggregate option share total each month thereafter. |
(5) |
Reflects a 1-for-3.309755 reverse stock split to occur immediately following the effectiveness of the registration statement covering the issuer's initial public offering. |
(6) |
Reflects the converted exercise price of each option share pursuant to the 1-for-3.309755 reverse stock split to occur immediately following the effectiveness of the registration statement covering the issuer's initial public offering. |