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 D Preferred Stock | (1) | (1) | Common Stock | 576,564 | $ (2) | I | See Footnote (3) |
Common Stock Warrants (right to buy) | 01/01/2015 | 06/06/2019 | Common Stock | 63,442 | $ (4) | I | See Footnote (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
NATIXIS PRIVATE EQUITY 5-7 RUE DE MONTTESSUY PARIS, I0 75007 |
X |
/s/ Authorized Signatory* | 02/12/2015 | |
**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) | The Issuer's Preferred Stock is convertible into Common Stock at any time at the holder's election. There is no expiration date for any series of Preferred Stock. |
(2) | All outstanding shares of the Issuer's Series D Preferred Stock will automatically convert on a 10.96-for-one basis into Common Stock as shown in column 3 immediately upon the closing of the Issuer's initial public offering, for no additional consideration. |
(3) | Represents shares and warrants held by NPE Coinvest ("NC"). Natixis Private Equity ("NPE") owns 100% of NC. NPE disclaims beneficial ownership of these securities and this report shall not be deemed an admission that NPE is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein.Voting and investment power over the shares held by NC may be deemed to be shared with NPE due to its parent relationship. Each of Dominique Sabassier ("Sabassier") and Cyrille Marcilhacy ("Marcilhacy ") are officers of NPE. Each of Sabassier and Marcilhacy disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interest therein. |
(4) | The per-share exercise price will be equal to the price per share at which shares of Common Stock are sold to the public pursuant to the Company's initial public offering. |
Remarks: *Signed under power of attorney on behalf of Reporting Person |