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, 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. | 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 E Preferred Stock (2) | 07/23/2007 | Â (2) | Class A Common Stock | 7,444,168 (2) | $ (2) | I | By L.P. (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
LIPTAK ROBERT VALLEY FORGE BUSINESS CENTER 2560 GENERAL ARMISTEAD AVENUE AUDUBON, PA 19403 |
 X |  X |  |  |
/s/ Robert W. Liptak | 08/02/2012 | |
**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) | Clarus Ventures I Management, L.P. ("Clarus I Management") is the sole general partner of Clarus Lifesciences I, L.P. and Clarus Ventures I, LLC ("Clarus I GPLLC") is the sole general partner of Clarus I Management. Mr. Liptak is a managing director of Clarus I GPLLC. As a managing director of Clarus I GPLLC, Mr. Liptak has shared voting and disposition power related to these shares and disclaims beneficial ownership of these shares. |
(2) | The Series E Preferred Stock is convertible into the Company's Class A Common Stock, currently on a one-for-one basis, and will automatically convert into Class A Common Stock upon the closing of the Company's initial public offering. The Series E Preferred Stock has no expiration date. |