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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 A Convertible Preferred Stock | (1) | 02/19/2014 | C | 1,638,450 | (1) | (4) | Common Stock | 289,991 | $ 0 | 0 | D (2) | ||||
Series B Convertible Preferred Stock | (1) | 02/19/2014 | C | 3,165,187 | (1) | (4) | Common Stock | 560,211 | $ 0 | 0 | D (2) | ||||
Series C Convertible Preferred Stock | (1) | 02/19/2014 | C | 841,493 | (1) | (4) | Common Stock | 148,936 | $ 0 | 0 | D (2) | ||||
Series A Convertible Preferred Stock | (1) | 02/19/2014 | C | 561,550 | (1) | (4) | Common Stock | 99,389 | $ 0 | 0 | I | By TVM Life Sciences Ventures VI LP (3) | |||
Series B Convertible Preferred Stock | (1) | 02/19/2014 | C | 1,084,813 | (1) | (4) | Common Stock | 192,003 | $ 0 | 0 | I | By TVM Life Sciences Ventures VI LP (3) | |||
Series C Convertible Preferred Stock | (1) | 02/19/2014 | C | 288,407 | (1) | (4) | Common Stock | 51,045 | $ 0 | 0 | I | By TVM Life Sciences Ventures VI LP (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
TVM Life Science Ventures VI GmbH & Co KG C/O TVM CAPITAL GROUP OTTOSTRASSE 4 MUNICH, 2M 80333 |
X | X | ||
Birner Hubert C/O TVM CAPITAL GROUP OTTOSTRASSE 4 MUNICH, 2M 80333 |
X | |||
Fischer Stefan C/O TVM CAPITAL GROUP OTTOSTRASSE 4 MUNICH, 2M 80333 |
X | |||
Goll Alexandra C/O TVM CAPITAL GROUP OTTOSTRASSE 4 MUNICH, 2M 80333 |
X | |||
Polack Axel C/O TVM CAPITAL GROUP OTTOSTRASSE 4 MUNICH, 2M 80333 |
X | |||
SCHUHSLER HELMUT C/O TVM CAPITAL GROUP OTTOSTRASSE 4 MUNICH, 2M 80333 |
X | X | ||
TVM Life Science Ventures VI LP C/O TVM CAPITAL GROUP OTTOSTRASSE 4 MUNICH, 2M 80333 |
X |
/s/ Stefan Fischer, Authorized Officer /s/ Josef Moosholzer, Authorized Officer | 02/20/2014 | |
**Signature of Reporting Person | Date | |
/s/ Rolf Starck, Attorney-in-Fact for Hubert Birner | 02/20/2014 | |
**Signature of Reporting Person | Date | |
/s/ Rolf Starck, Attorney-in-Fact for Stefan Fischer | 02/20/2014 | |
**Signature of Reporting Person | Date | |
/s/ Rolf Starck, Attorney-in-Fact for Alexandra Goll | 02/20/2014 | |
**Signature of Reporting Person | Date | |
/s/ Rolf Starck, Attorney-in-Fact for Axel Polack | 02/20/2014 | |
**Signature of Reporting Person | Date | |
/s/ Rolf Starck, Attorney-in-Fact for Helmut Schuhsler | 02/20/2014 | |
**Signature of Reporting Person | Date | |
/s/ Stefan Fischer, Director /s/ Josef Moosholzer, Officer | 02/20/2014 | |
**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 Series A, Series B and Series C Convertible Preferred Stock converted into Common Stock on a 1-for-5.65 basis upon the closing of the issuer's initial public offering without payment of consideration. |
(2) | The shares are directly held by TVM Life Sciences Ventures VI GMBH & Co. KG ("TVM VI"). Alexandra Goll ("Goll"), Helmut Schuhsler ("Schuhsler"), Hubert Birner ("Birner"), Stefan Fischer ("Fischer") and Alex Polack ("Polack") are members of the investment committee of TVM Life Sciences Ventures VI Management VI Limited Partnership ("TVM VI Management"), a special limited partner of TVM VI, with voting and dispositive power over the shares held by TVM VI. TVM VI Management and these individuals each disclaim beneficial ownership of the shares held by TVM VI except to the extent of any pecuniary interest therein. |
(3) | The shares are directly held by TVM Life Sciences Ventures VI LP ("TVM VI LP"). Goll, Schuhsler, Birner, Fischer and Polack are members of the investment committee of TVM VI Management, a special limited partner of TVM VI LP, with voting and dispositive power over the shares held by TVM VI LP. TVM VI Management and these individuals each disclaim beneficial ownership of the shares held by TVM VI LP except to the extent of any pecuniary interest therein. |
(4) | Not applicable. |