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 | ||||
Convertible Notes | Â (2) | Â (2) | Series C Convertible Preferred Stock | $ 3,000,000 | $ 7 (2) | D | Â |
Series B Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 108,932 | $ 0 (2) | I | By Ventures (1) |
Series C Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 117,361 | $ 0 (2) | I | By Ventures (1) |
Convertible Notes | Â (2) | Â (2) | Series C Convertible Preferred Stock | $ 279,103 | $ 7 (2) | I | By Ventures (1) |
Series C Convertible Preferred Stock Warrants (Right To Buy) | Â (2) | Â (2) | Series C Convertible Preferred Stock | 13,355 | $ 6.4022 (2) | I | By Ventures (1) |
Common Stock Warrants (Right To Buy) | Â (3) | Â (3) | Common Stock | 5,564 | $ 0.85 (3) | I | By Ventures (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
AMGEN INC ONE AMGEN CENTER DRIVE THOUSAND OAKS, CA 91320 |
 |  X |  |  |
Amgen Ventures LLC ONE AMGEN CENTER DRIVE THOUSAND OAKS, CA 91320 |
 |  X |  |  |
/s/ David J. Scott, Senior Vice President, General Counsel and Secretary on behalf of Amgen Ventures LLC and Amgen Inc. | 12/11/2013 | |
**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) | Owned directly by Amgen Ventures LLC ("Ventures"), a wholly-owned subsidiary of Amgen Inc. ("Amgen"). Amgen may be deemed to beneficially own securities held by Ventures, but disclaims beneficial ownership of the securities reported herein except to the extent of its pecuniary interest therein. |
(2) | As more fully described in the Issuer's Registration Statement on Form S-1 (Registration No. 333-191811) (the "Registration Statement"), in connection with the Issuer's initial public offering (the "Offering"), upon the closing of the Offering, (i) each outstanding share of the Issuer's preferred stock will be converted on a one-for-one basis into the Issuer's common stock, (ii) certain warrants for the right to purchase Series C Convertible Preferred Stock will be exercised on a one-for-one basis at the exercise price reported herein and converted into common stock of the Issuer on a one-for-one basis, and (iii) the Issuer's common stock will be issued upon conversion of the convertible notes by dividing the face value of such notes plus accrued interest due on such notes by the initial public offering price of the Issuer's common stock. |
(3) | Represents warrants (the "Bridge Warrants") for the right to purchase common stock of the Issuer on a one-for-one basis at the exercise price reported herein. The Bridge Warrants are exercisable at the option of the holder. |