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 | ||||
Warrants (right to buy) | 09/30/2013 | 09/30/2018 | Common Stock | 4,613 (1) | $ 5.75 | I | Alta BioPharma Partners III GmbH & Co. Beteiligungs KG (1) |
Warrants (right to buy) | 09/30/2013 | 09/30/2018 | Common Stock | 68,693 (2) | $ 5.75 | D | |
Warrants (right to buy) | 09/30/2013 | 09/30/2018 | Common Stock | 1,692 (3) | $ 5.75 | I | Alta Embarcadero BioPharma Partners III, LLC (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
ALTA BIOPHARMA PARTNERS III LP ONE EMBARCADERO CENTER SUITE 3700 SAN FRANCISCO, CA 94111 |
X | |||
ALTA BIOPHARMA PARTNERS III GMBH & CO BETEILIGUNGS KG ONE EMBARCADERO CENTER SUITE 3700 SAN FRANCISCO, CA 94111 |
X | |||
ALTA EMBARCADERO BIOPHARMA PARTNERS III LLC ONE EMBARCADERO CENTER SUITE 3700 SAN FRANCISCO, CA 94111 |
X |
/s/ Edward E. Penhoet | 10/11/2013 | |
**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) | The securities are held by Alta BioPharma Partners III GmbH & Co. Beteiligungs KG ("ABP III KG"). Alta BioPharma Management Partners III, LLC ("ABMP") is the managing imited partner of ABP III KG. ABMP disclaims beneficial ownership of these securities except to the extent of any pecuniary interest therein. |
(2) | The securities are held by Alta BioPharma Partners III, L.P. ("ABP III"). ABMP is the general partner of ABP III. ABMP disclaims beneficial ownership of these securities except to the extent of any pecuniary interest therein. |
(3) | The securities are held by Alta Embarcadero BioPharma Partners III, LLC ("AEBP III"). ABMP is the manager of AEBP III. ABMP disclaims beneficial ownership of these securities except to the extent of any pecuniary interest therein. |