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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 C Convertible Preferred Stock Warrant (right to buy) | $ 4.5 | 11/14/2006 | X | 21,984 | (5) | 03/12/2009 | Common Stock | 21,984 | (1) | 0 (6) | I (2) | By Delphi Ventures V, L.P. | |||
Series C Convertible Preferred Stock | (4) | 11/14/2006 | X | 21,984 | (5) | (1) | Common Stock | 21,984 | (1) | 0 (6) | I (2) | By Delphi Ventures V, L.P. | |||
Series C Convertible Preferred Stock Warrant (right to buy) | $ 4.5 | 11/14/2006 | X | 239 | (5) | 03/12/2009 | Common Stock | 239 | (1) | 0 (6) | I (3) | By Delphi BioInvestments V, L.P. | |||
Series C Convertible Preferred Stock | (4) | 11/14/2006 | X | 239 | (5) | (1) | Common Stock | 239 | (1) | 0 (6) | I (3) | By Delphi BioInvestments V, L.P. | |||
Series C Convertible Preferred Stock | (4) | 11/15/2006 | C | 681,498 | (5) | (1) | Common Stock | 681,498 | (1) | 0 (6) | I (2) | By Delphi Ventures V, L.P. | |||
Series C Convertible Preferred Stock | (4) | 11/15/2006 | C | 7,391 | (5) | (1) | Common Stock | 7,391 | (1) | 0 (6) | I (3) | By Delphi BioInvestments V, L.P. |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DELPHI MANAGEMENT PARTNERS V LLC 3000 SAND HILL ROAD BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X | |||
DELPHI VENTURES V LP 3000 SAND HILL ROAD BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X | |||
DELPHI BIOINVESTMENTS V LP 3000 SAND HILL ROAD BUILDING 1, SUITE 135 MENLO PARK, CA 94025 |
X |
/s/ David L. Douglass, Managing Member | 11/16/2006 | |
**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) | Not applicable. |
(2) | The reported securities are owned directly by Delphi Ventures V, L.P. and indirectly by Delphi Management Partners V, LLC, as general partner of Delphi Ventures V, L.P. Delphi Management Partners V, LLC disclaims beneficial ownership of these shares except to the extent of its pecuniary interest therein. Delphi BioInvestments V, L.P. disclaims beneficial ownership of these securities. |
(3) | The reported securities are owned directly by Delphi BioInvestments V, L.P. and indirectly by Delphi Management Partners V, LLC, as general partner of Delphi BioInvestments V, L.P. Delphi Management Partners V, LLC disclaims beneficial ownership of these shares except to the extent of its pecuniary interest therein. Delphi Ventures V, L.P. disclaims beneficial ownership of these securities. |
(4) | 1-for-1. |
(5) | Immediately. |
(6) | Following all transactions reported hereunder, the reporting entities do not own any Warrants to purchase shares of Series C Convertible Preferred Stock and do not own any shares of Series C Convertible Preferred Stock. |
Remarks: The reporting entities ceased to be 10% owners as of November 15, 2006. |