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) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series B Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
1,419,244
|
$
(1)
|
I
|
By Frazier Technology Ventures II, L.P.
(2)
|
Series C Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
256,365
|
$
(1)
|
I
|
By Frazier Technology Ventures II, L.P.
(2)
|
Series D Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
188,536
|
$
(1)
|
I
|
By Frazier Technology Ventures II, L.P.
(2)
|
Series G Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
324,023
|
$
(1)
|
I
|
By Frazier Technology Ventures II, L.P.
(2)
|
* |
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) |
Each share of Issuer's Preferred Stock automatically converts into Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering and has no expiration date. |
(2) |
These shares are owned directly by Frazier Technology Ventures II, L.P. ("Frazier"). Frazier's sole general partner is FTVM II, L.P. ("FTVM II") and FTVM II's sole general partner is Frazier Technology Management, L.L.C. ("Frazier Tech Management"). Len Jordan is a managing member of Frazier Tech Management. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose. Len Jordan is a director of Issuer. |