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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 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 B Preferred Stock | (1) | 02/19/2015 | C | 524,998 | (1) | (1) | Common Stock | 524,998 | $ 0 | 0 | I | See Footnote (2) (3) | |||
Series C Preferred Stock | (4) | 02/19/2015 | C | 169,306 | (4) | (4) | Common Stock | 169,306 | $ 0 | 0 | I | See Footnote (2) (5) | |||
Series D Preferred Stock | (6) | 02/19/2015 | C | 261,314 | (6) | (6) | Common Stock | 261,314 | $ 0 | 0 | I | See Footnote (2) (7) | |||
Convertible Promissory Note | $ 4.2 | 02/19/2015 | P | $ 580,415 | 02/19/2015 | 06/06/2015 | Common Stock | 138,194 | $ 580,415 | $ 580,415 | I | See Footnote (2) (10) | |||
Convertible Promissory Note | $ 4.2 | 02/19/2015 | C | $ 580,415 | 02/19/2015 | 06/06/2015 | Common Stock | 138,194 | $ 0 | 0 | I | See Footnote (2) (10) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
IPSA (INNOVEN PARTENAIRES S.A.) 10 RUE DE LA PAIX PARIS, I0 75002 |
X |
/s/ Authorized Signatory* | 02/23/2015 | |
**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) | Upon closing of the Issuer's initial public offering, each share of Series B Preferred Stock converted automatically into shares of common stock of the Issuer on a 10.94-for-one basis, and had no expiration date. |
(2) | Innoven Partenaires S.A. ("IPSA") is the manager of each of Innoven 2002 FCPI No.6, Innoven 2003 FCPI No.7, FCPI Innoven Europe, FCPI Innoven Europe 2, FCPI Innoven Europe 3, FCPI Innoven Capital, FCPI Innoven Capital 2, FCPI Poste Innovation, FCPI Poste Innovation 2, FCPI Poste Innovation 3, FCPI Poste Innovation 5, FCPI Poste Innovation 6, FCPI Poste Innovation 9 and FCPI La Banque Postale Innovation 1 (collectively, the "Funds"). Voting and investment power over the shares held by each of the Funds may be deemed to be shared with IPSA. Each of Jean-Michel Paulhac ("Paulhac") and Thomas Balland ("Balland ") are directors of IPSA. Each of Paulhac and Balland 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. |
(3) | Represents 26,994, 71,111, 16,416, 711,099, 428,115, 599,019, 817,685, 2,203,862, 885,941, and 4,288 shares held by Innoven 2002 FCPI No.6, Innoven 2003 FCPI No.7, FCPI Innoven Europe, FCPI Poste Innovation, FCPI Poste Innovation 2, FCPI Poste Innovation 3, FCPI Poste Innovation 5, FCPI Poste Innovation 6, FCPI Poste Innovation 9, and FCPI La Banque Postale Innovation 1, respectively. |
(4) | Upon closing of the Issuer's initial public offering, each share of Series C Preferred Stock converted automatically into shares of common stock of the Issuer on a 9.60-for-one basis, and had no expiration date. |
(5) | Represents 324,574, 31,532, 217,235, 89,946, 139,349, 269,507 and 786,837 shares held by FCPI Innoven Europe, FCPI Innoven Europe 2, FCPI Poste Innovation, FCPI Poste Innovation 2, FCPI Poste Innovation 3, FCPI Poste Innovation 5 and FCPI La Banque Postale Innovation 1, respectively. |
(6) | Upon closing of the Issuer's initial public offering, each share of Series D Preferred Stock converted automatically into shares of common stock of the Issuer on a 10.96-for-one basis, and had no expiration date. |
(7) | Represents 1,163, 527,940, 429,985, 361,720, 84,327, 920,096, 219,702, 219,862, 216 and 104,236 shares held by FCPI Innoven Europe, FCPI Innoven Europe 2, FCPI Innoven Europe 3, FCPI Innoven Capital, FCPI Innoven Capital 2, FCPI Poste Innovation, FCPI Poste Innovation 2, FCPI Poste Innovation 3, and FCPI La Banque Postale Innovation 1, respectively. |
(8) | Represents 5,791, 7,865, 31,161, 50,953, 39,160, 32,943, 7,680, 230,238, 149,680, 193,633, 210,214, 200,716, 80,706 and 81,544 shares held by Innoven 2002 FCPI No.6, Innoven 2003 FCPI No.7, FCPI Innoven Europe, FCPI Innoven Europe 2, FCPI Innoven Europe 3, FCPI Innoven Capital, FCPI Innoven Capital 2, FCPI Poste Innovation, FCPI Poste Innovation 2, FCPI Poste Innovation 3, FCPI Poste Innovation 5, FCPI Poste Innovation 6, FCPI Poste Innovation 9 and FCPI La Banque Postale Innovation 1, respectively. |
(9) | Represents 5,791, 10,006, 36,191, 64,167, 39,160, 32,943, 15,230, 230,238, 149,680, 193,633, 280,566, 231,074, 80,706 and 91,103 shares held by Innoven 2002 FCPI No.6, Innoven 2003 FCPI No.7, FCPI Innoven Europe, FCPI Innoven Europe 2, FCPI Innoven Europe 3, FCPI Innoven Capital, FCPI Innoven Capital 2, FCPI Poste Innovation, FCPI Poste Innovation 2, FCPI Poste Innovation 3, FCPI Poste Innovation 5, FCPI Poste Innovation 6, FCPI Poste Innovation 9 and FCPI La Banque Postale Innovation 1, respectively. |
(10) | Represents 2,141, 5,030, 13,214, 7,550, 70,342, 30,358 and 9,559 shares held by Innoven 2003 FCPI No.7, FCPI Innoven Europe, FCPI Innoven Europe 2, FCPI Innoven Capital 2, FCPI Poste Innovation 5, FCPI Poste Innovation 6 and FCPI La Banque Postale Innovation 1, respectively. |
Remarks: *Signed under power of attorney on behalf of Reporting Person |