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-2 Convertible Preferred Stock | Â (1) | Â (1) | Common Stock | 317,039 | $ (2) | D (3) | Â |
Series B-1 Convertible Preferred Stock | Â (4) | Â (4) | Common Stock | 683,571 | $ (2) | D (3) | Â |
Series B-2 Convertibe Preferred Stock | Â (5) | Â (5) | Common Stock | 713,719 | $ (2) | D (3) | Â |
Series A-2 Convertible Preferred Stock | Â (1) | Â (1) | Common Stock | 62,814 | $ (2) | D (6) | Â |
Series B-1 Convertible Preferred Stock | Â (4) | Â (4) | Common Stock | 135,434 | $ (2) | D (6) | Â |
Series B-2 Convertibe Preferred Stock | Â (5) | Â (5) | Common Stock | 141,407 | $ (2) | D (6) | Â |
Series A-2 Convertible Preferred Stock | Â (1) | Â (1) | Common Stock | 4,322 | $ (2) | D (7) | Â |
Series B-1 Convertible Preferred Stock | Â (4) | Â (4) | Common Stock | 9,318 | $ (2) | D (7) | Â |
Series B-2 Convertibe Preferred Stock | Â (5) | Â (5) | Common Stock | 9,729 | $ (2) | D (7) | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SOFINNOVA VENTURE PARTNERS VI L P 2800 SAND HILL ROAD, SUITE 150 MENLO PARK, CA 94025 |
 |  X |  |  |
Sofinnova Management VI, L.L.C. 2800 SAND HILL ROAD, SUITE 150 MENLO PARK, CA 94025 |
 |  X |  |  |
Sofinnova Venture Affiliates VI LP 2800 SAND HILL ROAD, SUITE 150 MENLO PARK, CA 94025 |
 |  X |  |  |
Sofinnova Venture Partners VI GmbH & Co. KG 2800 SAND HILL ROAD, SUITE 150 MENLO PARK, CA 94025 |
 |  X |  |  |
POWELL MICHAEL C/O SOFINNOVA VENTURES 2800 SAND HILL ROAD, SUITE 150 MENLO PARK, CA 94025 |
 |  X |  |  |
Buatois Eric C/O SOFINNOVA VENTURES 2800 SAND HILL ROAD, SUITE 150 MENLO PARK, CA 94025 |
 |  X |  |  |
Azan Alain 2800 SAND HILL ROAD, SUITE 150 MENLO PARK, CA 94025 |
 |  X |  |  |
HEALY JAMES C/O SOFINNOVA VENTURES 2800 SAND HILL ROAD, SUITE 150 MENLO PARK, CA 94025 |
 X |  X |  |  |
/s/ Nathalie Auber, Attorney-in-Fact for Sofinnova Venture Partners VI, L.P. | 12/22/2011 | |
**Signature of Reporting Person | Date | |
/s/ Nathalie Auber, Attorney-in-Fact for Sofinnova Venture Partners VI GmbH & Co. KG | 12/22/2011 | |
**Signature of Reporting Person | Date | |
/s/ Nathalie Auber, Attorney-in-Fact for Sofinnova Venture Affiliates VI, L.P. | 12/22/2011 | |
**Signature of Reporting Person | Date | |
/s/ Nathalie Auber, Attorney-in-Fact for Sofinnova Management VI, L.L.C. | 12/22/2011 | |
**Signature of Reporting Person | Date | |
/s/ Nathalie Auber, Attorney-in-Fact for Michael F. Powell | 12/22/2011 | |
**Signature of Reporting Person | Date | |
/s/ Nathalie Auber, Attorney-in-Fact for Alain L. Azan | 12/22/2011 | |
**Signature of Reporting Person | Date | |
/s/ Nathalie Auber, Attorney-in-Fact for Eric P. Buatois | 12/22/2011 | |
**Signature of Reporting Person | Date | |
/s/ Nathalie Auber, Attorney-in-Fact for James Healy | 12/22/2011 | |
**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) | The Series A-2 Convertible Preferred Stock is convertible on a one-for-one basis at any time at the holder's election and has no expiration date. |
(2) | Not applicable. |
(3) | Shares are held by Sofinnova Venture Partners VI, L.P. ("SV VI"). Sofinnova Management VI, L.L.C. ("SV LLC") is the general partner of SV VI and James I. Healy ("Healy"), a director of the issuer, Michael F. Powell ("Powell"), Alain L. Azan ("Azan") and Eric P. Buatois ("Buatois"), the managing members of SV LLC, may be deemed to share voting and dispositive power over the shares held by such entities. |
(4) | The Series B-1 Convertible Preferred Stock is convertible on a one-for-one basis at any time at the holder's election and has no expiration date. |
(5) | The Series B-2 Convertible Preferred Stock is convertible on a one-for-one basis at any time at the holder's election and has no expiration date. |
(6) | Shares are held by Sofinnova Venture Partners VI GmbH & Co. KG ("SV KG"). SV LLC is the managing limited partner of SV KG, and Healy, Powell, Azan and Buatois, the managing members of SV LLC, may be deemed to share voting and dispositive power over the shares held by such entities. |
(7) | Shares are held by Sofinnova Venture Affiliates VI L.P. ("SV A"). SV LLC is the general partner of SV A, and Healy, Powell, Azan and Buatois, the managing members of SV LLC, may be deemed to share voting and dispositive power over the shares held by such entities. |
 Remarks: SV LLC and its managing members disclaim benefical ownership of these shares except to the extent of any pecuniary interest therein, and the filing of this report is not an admission that SV LLC or any of its managing members is the beneficial owner of these shares for purposes of Section 16 or for any other purpose. This Form 3/A is being filed to add reporting persons who were omitted in the prior filing and correct share totals as a result of such additions. |