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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, 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. | |||
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 A Preferred Stock | (1) | 10/03/2012 | C | 1,346,877 | (1) | (1) | Common Stock | 1,346,877 | $ 0 | 0 | I | See footnotes (2) (7) | |||
Series A Preferred Stock | (1) | 10/03/2012 | C | 102,325 | (1) | (1) | Common Stock | 102,325 | $ 0 | 0 | I | See footnotes (3) (7) | |||
Series A Preferred Stock | (1) | 10/03/2012 | C | 32,622 | (1) | (1) | Common Stock | 32,622 | $ 0 | 0 | I | See footnotes (4) (7) | |||
Series A Preferred Stock | (1) | 10/03/2012 | C | 7,826 | (1) | (1) | Common Stock | 7,826 | $ 0 | 0 | I | See footnotes (5) (7) | |||
Series A Preferred Stock | (1) | 10/03/2012 | C | 7,468 | (1) | (1) | Common Stock | 7,468 | $ 0 | 0 | I | See footnotes (6) (7) | |||
Series B Preferred Stock | (1) | 10/03/2012 | C | 3,743,844 | (1) | (1) | Common Stock | 3,743,844 | $ 0 | 0 | I | See footnotes (2) (7) | |||
Series B Preferred Stock | (1) | 10/03/2012 | C | 284,432 | (1) | (1) | Common Stock | 284,432 | $ 0 | 0 | I | See footnotes (3) (7) | |||
Series B Preferred Stock | (1) | 10/03/2012 | C | 108,359 | (1) | (1) | Common Stock | 108,359 | $ 0 | 0 | I | See footnotes (4) (7) | |||
Series B Preferred Stock | (1) | 10/03/2012 | C | 21,758 | (1) | (1) | Common Stock | 21,758 | $ 0 | 0 | I | See footnotes (5) (7) | |||
Series B Preferred Stock | (1) | 10/03/2012 | C | 20,762 | (1) | (1) | Common Stock | 20,762 | $ 0 | 0 | I | See footnotes (6) (7) | |||
Series C Preferred Stock | (1) | 10/03/2012 | C | 269,599 | (1) | (1) | Common Stock | 269,599 | $ 0 | 0 | I | See footnotes (2) (7) | |||
Series C Preferred Stock | (1) | 10/03/2012 | C | 20,481 | (1) | (1) | Common Stock | 20,481 | $ 0 | 0 | I | See footnotes (3) (7) | |||
Series C Preferred Stock | (1) | 10/03/2012 | C | 7,802 | (1) | (1) | Common Stock | 7,802 | $ 0 | 0 | I | See footnotes (4) (7) | |||
Series C Preferred Stock | (1) | 10/03/2012 | C | 1,566 | (1) | (1) | Common Stock | 1,566 | $ 0 | 0 | I | See footnotes (5) (7) | |||
Series C Preferred Stock | (1) | 10/03/2012 | C | 1,494 | (1) | (1) | Common Stock | 1,494 | $ 0 | 0 | I | See footnotes (6) (7) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
TRIDENT CAPITAL MANAGEMENT V LLC 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL FUND V LP 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL PARALLEL FUND V CV 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL FUND V PRINCIPALS FUND L P 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X | |||
TRIDENT CAPITAL FUND V AFFILIATES FUND LP 505 HAMILTON AVENUE, SUITE 200 PALO ALTO, CA 94301 |
X |
/s/ Donald R. Dixon, a Managing Director of Trident Capital Management-V, L.L.C. | 10/03/2012 | |
**Signature of Reporting Person | Date | |
/s/ Donald R. Dixon, a Managing Director of Trident Capital Management-V, L.L.C., the General Partner of Trident Capital Fund-V, L.P. | 10/03/2012 | |
**Signature of Reporting Person | Date | |
/s/ Donald R. Dixon, a Managing Director of Trident Capital Management-V, L.L.C., the General Partner of Trident Capital Parallel Fund-V, C.V. | 10/03/2012 | |
**Signature of Reporting Person | Date | |
/s/ Donald R. Dixon, a Managing Director of Trident Capital Management-V, L.L.C., the General Partner of Trident Capital Fund-V Principals Fund, L.P. | 10/03/2012 | |
**Signature of Reporting Person | Date | |
/s/ Donald R. Dixon, a Managing Director of Trident Capital Management-V, L.L.C., the General Partner of Trident Capital Fund-V Affiliates Fund, L.P. | 10/03/2012 | |
**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) | Each share of Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock automatically converted into Common Stock on a 1-for-1 basis upon the completion of the Issuer's initial public offering of Common Stock and had no expiration date. |
(2) | The reported securities are held directly by Trident Capital Fund-V, L.P. |
(3) | The reported securities are held directly by Trident Capital Parallel Fund-V, C.V. |
(4) | The reported securities are held directly by Trident Capital Fund-V Principals Fund, L.P. |
(5) | The reported securities are held directly by Trident Capital Fund-V Affiliates Fund, L.P. |
(6) | The reported securities are held directly by Trident Capital Fund-V Affiliates Fund (Q), L.P. |
(7) | Trident Capital Management-V, L.L.C. ("TCMV") serves as the general partner of each of Trident Capital Fund-V, L.P., Trident Capital Fund-V Affiliates Fund, L.P., Trident Capital Fund-V Affiliates Fund (Q), L.P. and Trident Capital Fund-V Principals Fund, L.P. and the sole investment general partner of Trident Capital Parallel Fund-V, C.V. As such, TCMV may be deemed to be the beneficial owner of the shares held directly by each of these Trident entities. TCMV disclaims beneficial ownership of these securities except to the extent of its pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purpose. |