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 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 | ||||
Warrant | (5) | 08/29/2013 | Common Stock | 404,080 | $ 2.34 | I | By limited partnership (1) (2) |
Warrant | (5) | 08/29/2013 | Common Stock | 27,137 | $ 2.34 | I | By limited partnership (2) (3) |
Warrant | (5) | 08/29/2013 | Common Stock | 9,958 | $ 2.34 | I | By limited liability company (2) (4) |
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 | |||
DELEAGE JEAN ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
X | |||
CHAMPSI FARAH ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
X | |||
PENHOET EDWARD ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
X | |||
HURWITZ EDWARD ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
X | |||
ALTA BIOPHARMA MANAGEMENT III LLC ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
X | |||
MARDUEL ALIX ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
X |
Alta BioPharma Partners III, L.P. By: Alta BioPharma Management III, LLC, its General Partner /s/ Jean Deleage, Director | 09/05/2008 | |
**Signature of Reporting Person | Date | |
By: Alta BioPharma Management III, LLC, it's Managing Limited Partner | 09/05/2008 | |
**Signature of Reporting Person | Date | |
/s/ Jean Deleage, Manager | 09/05/2008 | |
**Signature of Reporting Person | Date | |
/s/ Jean Deleage | 09/05/2008 | |
**Signature of Reporting Person | Date | |
/s/ Farah Champsi | 09/05/2008 | |
**Signature of Reporting Person | Date | |
/s/ Edward Penhoet | 09/05/2008 | |
**Signature of Reporting Person | Date | |
/s/ Edward Hurwitz | 09/05/2008 | |
**Signature of Reporting Person | Date | |
/s/ Jean Deleage, Director | 09/05/2008 | |
**Signature of Reporting Person | Date | |
/s/ Alix Marduel | 09/05/2008 | |
**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) | These securities are held by Alta BioPharma Partners III, L.P. ("ABPIII"). |
(2) | Alta BioPharma Management III, LLC ("ABMIII") is the general partner of ABPIII and the managing limited partner of Alta BioPharma Partners III GmbH & Co. Beteiligungs KG("ABPIIIKG"). Jean Deleage, Farah Champsi, Edward Penhoet, Edward Hurwitz, and Alix Marduel are directors of ABMIII and managers of Alta Embarcadero BioPharma Partners III, LLC ("AEBPIII" and, along with ABMIII and ABPIIIKG, the "Funds")and exercise shared voting and investment power with respect to the securities held by the funds. Each of the reporting persons disclaims beneficial ownership of such securities, except to the extent of his, her or its proportionate pecuniary interest therein. |
(3) | These securities are held by ABPIIIKG. |
(4) | These securities are held by AEBPIII. |
(5) | These warrants are immediately exercisable. |