|
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 or Section 30(h) of the Investment Company Act of 1940 |
|
| |||||||||||||||||||||||||||||||||||||||||||||||||
|
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) |
||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Warrant | $ 2.23 | 10/05/2009 | P | 95,907 | (5) | 10/05/2014 | Common Stock | 95,907 | $ 0 (6) | 499,987 | D (1) (2) | ||||
Warrant | $ 2.23 | 10/05/2009 | P | 6,441 | (5) | 10/05/2014 | Common Stock | 6,441 | $ 0 (6) | 33,578 | I | See footnotes (2) (3) | |||
Warrant | $ 2.23 | 10/05/2009 | P | 2,363 | (5) | 10/05/2014 | Common Stock | 2,363 | $ 0 (6) | 12,321 | I | See footnotes (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 |
Former 10% owner | |||
ALTA BIOPHARMA PARTNERS III GMBH & CO BETEILIGUNGS KG ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
Former 10% owner | |||
ALTA BIOPHARMA MANAGEMENT III LLC ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
Former 10% owner | |||
ALTA EMBARCADERO BIOPHARMA PARTNERS III LLC ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
Former 10% owner | |||
DELEAGE JEAN ONE EMBARCADERO CENTER SUITE 3700 SAN FRANCISCO, CA 94111 |
Former 10% owner | |||
CHAMPSI FARAH ONE EMBARCADERO CENTER SUITE 3700 SAN FRANCISCO, CA 94132 |
Former 10% owner | |||
PENHOET EDWARD ONE EMBARCADERO CENTER SUITE 3700 SAN FRANCISCO, CA 94111 |
Former 10% owner | |||
HURWITZ EDWARD ONE EMBARCADERO CENTER, SUITE 3700 SAN FRANCISCO, CA 94111 |
Former 10% owner |
By Alta BioPharma Management III, LLC, /s/ Jean Deleage, Director | 10/06/2009 | |
**Signature of Reporting Person | Date | |
Alta BioPharma Management III, LLC, It's General Partner, /s/ Jean Deleage, Director | 10/06/2009 | |
**Signature of Reporting Person | Date | |
/s/ Jean Deleage, Director | 10/06/2009 | |
**Signature of Reporting Person | Date | |
/s/ Jean Deleage, Manager | 10/06/2009 | |
**Signature of Reporting Person | Date | |
/s/ Jean Deleage | 10/06/2009 | |
**Signature of Reporting Person | Date | |
/s/ Farah Champsi | 10/06/2009 | |
**Signature of Reporting Person | Date | |
/s/ Edward Penhoet | 10/06/2009 | |
**Signature of Reporting Person | Date | |
/s/ Edward Hurwitz | 10/06/2009 | |
**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) | These securities are held of record by Alta BioPharma Partners III, L.P.("ABPIII"). |
(2) | Alta BioPharma Management III, LLC ("ABMIII") is the General Partner of ABPIII and Managing Limited Partner of Alta BioPharma Partners III GmbH & Co. Beteiligungs KG ("ABPIIIKG"). Jean Deleage, Farah Champsi, Edward Penhoet, and Edward Hurwitz are directors of ABMIII and managers of Alta Embarcadero BioPharma Partners III, LLC ("AEBPIII" and, along with ABPIII and ABPIIIKG, the "Funds") and they exercise shared voting and investment power with respect to the shares owned by the Funds. Each reporting persons disclaims beneficial ownership of such securities, except to the extend of his or her pecuniary interest therein. |
(3) | These securities are held of record by ABPIIIKG. |
(4) | These securities are held of record by AEBPIII. |
(5) | These warrants are immediately exercisable. |
(6) | These warrants were issued pursuant to Securities Purchase Agreement ("SPA") dated September 29, 2009. For every share of stock purchased at $1.91 according to the SPA, 0.4 share of warrant was issued. |