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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 Redeemable Convertible Preferred Stock | (6) | 08/08/2007 | C | 3,126,441 (2) (9) | (10) | (10) | Common Stock | 1,400,764 (2) (11) | $ 0 | 0 | I | See footnote (2) | |||
Series B Redeemable Convertible Preferred Stock | (3) | 08/08/2007 | C | 1,388,497 (2) (12) | (10) | (10) | Common Stock | 504,098 (2) (13) | $ 0 | 0 | I | See footnote (2) | |||
Series C Redeemable Convertible Preferred Stock | (4) | 08/08/2007 | C | 5,410,898 (2) (14) | (10) | (10) | Common Stock | 1,728,718 (2) (15) | $ 0 | 0 | I | See footnote (2) | |||
Series D Redeemable Convertible Preferred Stock | (5) | 08/08/2007 | C | 1,920,580 (2) (16) | (10) | (10) | Common Stock | 613,601 (2) (17) | $ 0 | 0 | I | See footnote (2) | |||
Series A Redeemable Convertible Preferred Stock | (6) | 08/08/2007 | C | 171,707 | (10) | (10) | Common Stock | 76,931 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DAVOLI ROBERT E C/O VIRTUSA CORPORATION 2000 WEST PARK DRIVE WESTBOROUGH, MA 01581 |
X | X |
/s/ Thomas R. Holler, attorney-in-fact | 08/08/2007 | |
**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) | Includes total shares received upon conversion of Series A, B, C and D Redeemable Convertible Preferred Stock, of which 3,297,835 shares are held by Sigma Partners V, L.P., 755,806 shares are held by Sigma Associates V, L.P. and 193,540 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(2) | The reporting person may be deemed to be a beneficial owner of these shares as he is the managing director and general partner of Sigma Partners V, L.P., Sigma Associates V, L.P. and Sigma Investors V, L.P., which together these entities form a 13(d) group owning more than 10% of the Issuer's Common Stock. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. |
(3) | Each share of Series B Redeemable Convertible Preferred Stock automatically converted into 0.363 shares of Common Stock upon the Closing of the Issuer's initial public offering. |
(4) | Each share of Series C Redeemable Convertible Preferred Stock automatically converted into 0.319 shares of Common Stock upon the Closing of the Issuer's initial public offering. |
(5) | Each share of Series D Redeemable Convertible Preferred Stock automatically converted into 0.319 shares of Common Stock upon the Closing of the Issuer's initial public offering. |
(6) | Each share of Series A Redeemable Convertible Preferred Stock automaticllay converted into 0.448 shares of Common Stock upon the Closing of the Issuer's initial public offering. |
(7) | Includes 3,533,396 shares are held by Sigma Partners V, L.P., 784,800 shares are held by Sigma Associates V, L.P. and 207,374 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(8) | Includes shares received upon conversion of the shares of Series A Preferred Stock. |
(9) | Includes 2,142,757 shares are held by Sigma Partners V, L.P., 858,401 shares are held by Sigma Associates V, L.P. and 125,283 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(10) | Shares of Series A, B, C and D Redeemable Convertible Preferred Stock automatically converted into shares of the Issuer's Common Stock upon the Closing of the Issuer's initial public offering. |
(11) | Includes 960,037 shares are held by Sigma Partners V, L.P., 384,596 shares are held by Sigma Associates V, L.P. and 56,131 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(12) | Includes 969,131 shares are held by Sigma Partners V, L.P., 362,347 shares are held by Sigma Associates V, L.P. and 57,019 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(13) | Includes 351,847 shares are held by Sigma Partners V, L.P., 131,551 shares are held by Sigma Associates V, L.P. and 20,700 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(14) | Includes 4,586,180 shares are held by Sigma Partners V, L.P., 555,166 shares are held by Sigma Associates V, L.P. and 269,552 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(15) | Includes 1,465,232 shares are held by Sigma Partners V, L.P., 177,368 shares are held by Sigma Associates V, L.P. and 86,118 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(16) | Includes 1,629,854 shares are held by Sigma Partners V, L.P., 194,972 shares are held by Sigma Associates V, L.P. and 95,754 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |
(17) | Includes 520,719 shares are held by Sigma Partners V, L.P., 62,291 shares are held by Sigma Associates V, L.P. and 30,591 shares are held by Sigma Investors V, L.P. and a 1-for-3.13 stock split of the Issuer's Common Stock that occurred on 7/18/2007. |