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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 | ||||||||
Warrant to purchase Common Stock | $ 3.4 | 05/29/2012 | P | 60,789 | 11/29/2012 | 11/29/2017 | Common Stock | 60,789 | $ 0.125 | 60,789 | I | See Footnote (1) (1) | |||
Warrant to purchase Common Stock | $ 3.4 | 05/29/2012 | P | 3,268 | 11/29/2012 | 11/29/2017 | Common Stock | 3,268 | $ 0.125 | 3,268 | I | See Footnote (2) (2) | |||
Warrant to purchase Common Stock | $ 3.4 | 05/29/2012 | P | 188,020 | 11/29/2012 | 11/29/2017 | Common Stock | 188,020 | $ 0.125 | 188,020 | I | See Footnote (3) (3) | |||
Warrant to purchase Common Stock | $ 3.4 | 05/29/2012 | P | 4,151 | 11/29/2012 | 11/29/2017 | Common Stock | 4,151 | $ 0.125 | 4,151 | I | See Footnote (4) (4) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
WAN MARK A 3200 ALPINE ROAD PORTOLA VALLEY, CA 94028 |
X | X | ||
JAEGER WILFRED E 3200 ALPINE DRIVE PORTOLA VALLEY, CA 94028 |
X | |||
THREE ARCH PARTNERS III LP 3200 ALPINE DRIVE PORTOLA VALLEY, CA 94028 |
X | |||
THREE ARCH ASSOCIATES III LP 3200 ALPINE ROAD PORTOLA VALLEY, CA 94028 |
X | |||
THREE ARCH PARTNERS L P 3200 ALPINE ROAD PORTOLA VALLEY, CA 94028 |
X | |||
THREE ARCH ASSOCIATES L P 3200 ALPINE ROAD PORTOLA VALLEY, CA 94028 |
X |
/s/ Steve Agelopoulos, Attorney-in-Fact | 05/31/2012 | |
**Signature of Reporting Person | Date | |
/s/ Steve Agelopoulos, Attorney-in-Fact | 05/31/2012 | |
**Signature of Reporting Person | Date | |
/s/ Steve Agelopoulos, Attorney-in-Fact | 05/31/2012 | |
**Signature of Reporting Person | Date | |
/s/ Steve Agelopoulos, Attorney-in-Fact | 05/31/2012 | |
**Signature of Reporting Person | Date | |
/s/ Steve Agelopoulos, Attorney-in-Fact | 05/31/2012 | |
**Signature of Reporting Person | Date | |
/s/ Steve Agelopoulos, Attorney-in-Fact | 05/31/2012 | |
**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 shares are held by Three Arch Partners III, L.P. ("TAP III"). Three Arch Management III, L.L.C. ("TAM III"), the general partner of TAP III, has sole voting and dispositive power with respect to the securities held by TAP III. Mark A. Wan and Wilfred Jaeger, the managing members of TAM III, share the voting and dispositive power with respect to the shares hld by TAP III. Such persons and entities disclaim beneficial ownership of the shares held by TAP III except to the extent of any pecuniary interest therein. |
(2) | The shares are held by Three Arch Associates III, L.P. ("TAA III"). TAM III, the general partner of TAA III, has sole voting and dispositive power with respect to the securities held by TAA III. Mark A. Wan and Wilfred Jaeger, the managing members of TAM III, share the voting and dispositive power with respect to the shares hld by TAA III. Such persons and entities disclaim beneficial ownership of the shares held by TAA III except to the extent of any pecuniary interest therein. |
(3) | The shares are held by Three Arch Partners IV, L.P. ("TAP IV"). Three Arch Management IV, L.L.C. ("TAM IV"), the general partner of TAP IV, has sole voting and dispositive power with respect to the securities held by TAP IV. Mark A. Wan and Wilfred Jaeger, the managing members of TAM IV, share the voting and dispositive power with respect to the shares hld by TAP IV. Such persons and entities disclaim beneficial ownership of the shares held by TAP IV except to the extent of any pecuniary interest therein. |
(4) | The shares are held by Three Arch Associates IV, L.P. ("TAA IV"). TAM IV, the general partner of TAA IV, has sole voting and dispositive power with respect to the securities held by TAA IV. Mark A. Wan and Wilfred Jaeger, the managing members of TAM IV, share the voting and dispositive power with respect to the shares hld by TAA IV. Such persons and entities disclaim beneficial ownership of the shares held by TAA IV except to the extent of any pecuniary interest therein. |