3: Initial statement of beneficial ownership of securities
Published on October 14, 2015
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 | ||||
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 595,436 (2) | $ (1) | I | See Footnote (3) |
Reporting Owners
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MPM BIOVENTURES V, L.P. C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X | |||
MPM ASSET MANAGEMENT INVESTORS BV5 LLC C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X | |||
MPM BIOVENTURES V GP LLC C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X | |||
MPM BIOVENTURES V LLC C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X | |||
GADICKE ANSBERT C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X | |||
EVNIN LUKE C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X | |||
KAILIAN VAUGHN M C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X | |||
Scopa James Paul C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X | |||
Foley Todd C/O MPM ASSET MANAGEMENT 450 KENDALL STREET CAMBRIDGE, MA 02142 |
X |
Signatures
By Ansbert Gadicke, member of MPM BioVentures V LLC, the managing member of MPM BioVentures V GP LLC /s/ Ansbert Gadicke | 10/14/2015 | |
**Signature of Reporting Person | Date | |
By Ansbert Gadicke, member of MPM BioVentures V LLC, the managing member of MPM BioVentures V GP LLC, the general partner of MPM BioVentures V, L.P. /s/ Ansbert Gadicke | 10/14/2015 | |
**Signature of Reporting Person | Date | |
By Ansbert Gadicke, member of MPM BioVentures V LLC, the manager of MPM Asset Management Investors BV5 LLC /s/ Ansbert Gadicke | 10/14/2015 | |
**Signature of Reporting Person | Date | |
/s/ Luke Evnin | 10/14/2015 | |
**Signature of Reporting Person | Date | |
/s/ Todd Foley | 10/14/2015 | |
**Signature of Reporting Person | Date | |
/s/ Ansbert Gadicke | 10/14/2015 | |
**Signature of Reporting Person | Date | |
/s/ Vaughn M. Kailian | 10/14/2015 | |
**Signature of Reporting Person | Date | |
/s/ James Paul Scopa | 10/14/2015 | |
**Signature of Reporting Person | Date |
Explanation of Responses:
* | 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 shares of Series B Convertible Preferred Stock (the "Series B Shares") will convert automatically into Common Stock, on a 1-for-0.03571 basis, immediately prior to the closing of the Issuer's initial public offering, and have no expiration date. |
(2) | Reflects the conversion of the Series B Shares into shares of Common Stock. |
(3) | The shares are held as follows: 573,170 by MPM BioVentures V, L.P. ("BV V") and 22,266 by MPM Asset Management Investors BV5 LLC ("AM BV5"). MPM BioVentures V GP LLC ("BV GP") is the general partner of BV V. MPM BioVentures V LLC ("BV LLC") is the managing member of BV GP and AM BV5. Ansbert Gadicke, Luke Evnin, Vaughn M. Kailian, James Paul Scopa and Todd Foley are the members of BV LLC. Each Reporting Person disclaims beneficial ownership of the securities except to the extent of his or its respective pecuniary interest therein. |