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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 | 11,801 | (1) | (1) | Common Stock | 11,801 | $ 0 | 0 | D | ||||
Series C Preferred Stock | (2) | 02/19/2015 | C | 17,363 | (2) | (2) | Common Stock | 17,363 | $ 0 | 0 | D | ||||
Series D Preferred Stock | (3) | 02/19/2015 | C | 140,685 | (3) | (3) | Common Stock | 140,685 | $ 0 | 0 | D | ||||
Convertible Promissory Note | $ 4.2 | 02/19/2015 | P | $ 1,013,334 | 02/19/2015 | 06/06/2015 | Common Stock | 241,270 | $ 1,013,334 | $ 1,013,334 | D | ||||
Convertible Promissory Note | $ 4.2 | 02/19/2015 | C | $ 1,013,334 | 02/19/2015 | 06/06/2015 | Common Stock | 241,270 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Ventech Capital II 47 AVENUE DE L'OPERA PARIS CEDEX 07, I0 75002 |
X |
/s/ Alain Caffi, Chairman of Managing Board* | 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) | 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. |
(3) | 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. |
Remarks: *Signed under power of attorney on behalf of Reporting Person |