UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
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) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 1,923,912 | $ 0 | I | See Footnote (4) |
Series A Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 44,798 | $ 0 | I | See Footnote (5) |
Series B Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 3,663,703 | $ 0 | I | See Footnote (4) |
Series B Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 86,249 | $ 0 | I | See Footnote (5) |
Series C Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 998,371 | $ 0 | I | See Footnote (4) |
Series C Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 23,389 | $ 0 | I | See Footnote (5) |
Series D Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 495,503 | $ 0 | I | See Footnote (4) |
Series D Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 11,613 | $ 0 | I | See Footnote (5) |
Series E Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 294,011 | $ 0 | I | See Footnote (4) |
Series E Convertible Preferred Stock (1) | Â (2) | Â (3) | Common Stock | 6,894 | $ 0 | I | See Footnote (5) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CMEA VENTURES VI LP ONE LETTERMAN DRIVE BUILDING C, SUITE CM500 SAN FRANCISCO, CA 94129-2402 |
 |  X |  |  |
CMEA Ventures VI GmbH & Co. KG ONE LETTERMAN DRIVE BUILDING C, SUITE CM500 SAN FRANCISCO, CA 94129-2402 |
 |  X |  |  |
CMEA Ventures VI Management, L.P. ONE LETTERMAN DRIVE BUILDING C, SUITE CM500 SAN FRANCISCO, CA 94129-2402 |
 |  X |  |  |
BARUCH THOMAS R ONE LETTERMAN DRIVE BUILDING C, SUITE CM500 SAN FRANCISCO, CA 94129-2402 |
 |  X |  |  |
Collier David J ONE LETTERMAN DRIVE BUILDING C, SUITE CM500 SAN FRANCISCO, CA 94129-2402 |
 |  X |  |  |
Handelsman Karl D. ONE LETTERMAN DRIVE BUILDING C, SUITE CM500 SAN FRANCISCO, CA 94129-2402 |
 |  X |  |  |
Sohail Faysal A. ONE LETTERMAN DRIVE BUILDING C, SUITE CM500 SAN FRANCISCO, CA 94129-2402 |
 |  X |  |  |
Watson James F ONE LETTERMAN DRIVE BUILDING C, SUITE CM500 SAN FRANCISCO, CA 94129-2402 |
 |  X |  |  |
CMEA VENTURES VI, L.P. By: CMEA Ventures VI Management, L.P., its General Partner By: /s/ David J. Collier, General Partner | 11/17/2011 | |
**Signature of Reporting Person | Date | |
CMEA VENTURES VI GMBH & CO. KG By: CMEA Ventures VI Management, L.P., its managing limited partner By: /s/ David J. Collier, General Partner | 11/17/2011 | |
**Signature of Reporting Person | Date | |
CMEA VENTURES VI MANAGEMENT, L.P. By: /s/ David J. Collier, General Partner | 11/17/2011 | |
**Signature of Reporting Person | Date | |
/s/ Thomas R. Baruch | 11/17/2011 | |
**Signature of Reporting Person | Date | |
/s/ David J. Collier | 11/17/2011 | |
**Signature of Reporting Person | Date | |
/s/ Karl D. Handelsman | 11/17/2011 | |
**Signature of Reporting Person | Date | |
/s/ Faysal A. Sohail | 11/17/2011 | |
**Signature of Reporting Person | Date | |
/s/ James F. Watson | 11/17/2011 | |
**Signature of Reporting Person | Date |
* | 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, Series B, Series C, Series D and Series E Convertible Preferred Stock will automatically convert on a 1-for-2 basis into common stock upon the consummation of the Issuer's initial public offering. |
(2) | The securities are immediately convertible. |
(3) | The expiration date is not relevant to the conversion of these securities. |
(4) | The shares are held by CMEA Ventures VI, L.P. ("CMEA Ventures VI"). CMEA Ventures VI Management, L.P. ("CMEA VI Management") is the general partner of CMEA Ventures VI. Thomas R. Baruch, David J. Collier, Karl D. Handelsman, Faysal A. Sohail and James F. Watson are the general partners of CMEA VI Management and, as such, have voting and investment power over the shares held by CMEA Ventures VI. Each of the Reporting Persons disclaims beneficial ownership of the shares reported herein, except to the extent of any proportionate pecuniary interest therein. |
(5) | The shares are held by CMEA Ventures VI GmbH & Co. KG ("CMEA Ventures VI GmbH"). CMEA Ventures VI Management, L.P. ("CMEA VI Management") is the managing limited partner of CMEA Ventures VI GmbH. Thomas R. Baruch, David J. Collier, Karl D. Handelsman, Faysal A. Sohail and James F. Watson are the general partners of CMEA VI Management and, as such, have voting and investment power over the shares held by CMEA Ventures VI GmbH. Each of the Reporting Persons disclaims beneficial ownership of the shares reported herein, except to the extent of any proportionate pecuniary interest therein. |