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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 | ||||||||
Common Stock | (1) | 04/30/2012 | C | 400,000 | (1) | (1) | Common Stock | 400,000 | $ 0 | 0 | I | By Atlantic Bridge Ventures GP Ltd. (2) | |||
Common Stock | (1) | 04/30/2012 | C | 271,155 | (1) | (1) | Common Stock | 271,155 | $ 0 | 0 | I | By Atlantic Bridge Ventures GP Ltd. (2) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Dillon Kevin E. 400 OYSTER POINT BOULEVARD, SUITE 325 SOUTH SAN FRANCISCO, CA 94080 |
X |
/s/ Erik Miller, Attorney-in-Fact. | 05/02/2012 | |
**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) | The convertible G2 Preferred Stock and H2 Preferred Stock stock automatically converted into shares of common stock upon the closing of the Issuer's initail public offering, on a one-for-one basis and has no expiration date. |
(2) | The Reporting Person is a managing partner of Atlantic Bridge Ventures GP Ltd. The Reporting Person shares voting and dispositive power over the securities held by this fund with Elaine Coughlan and Brian Long, each as Controlling Shareholders of the fund. Each of these individuals disclaim beneficial ownership of the reported securities except to the extent of his or her pecuniary interest therein. |