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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 | (2) | 11/19/2008 | C | 4,213 (1) (2) | (2) | (2) | Common Stock | 7,692,938 (1) (2) | $ 0 | 0 | I | Endeavour Capital Fund IV, L.P. | |||
Series C Preferred Stock | (3) | 11/19/2008 | C | 1,426.09 (1) (3) | (3) | (3) | Common Stock | 831,886 (1) (3) | $ 0 | 0 | I | Endeavour Capital Fund IV, L.P. | |||
Series A Preferred Stock | (2) | 11/19/2008 | C | 258 (1) (2) | (2) | (2) | Common Stock | 471,108 (1) (2) | $ 0 | 0 | I | Endeavour Associates Fund IV, L.P. | |||
Series C Preferred Stock | (3) | 11/19/2008 | C | 87.44 (1) (3) | (3) | (3) | Common Stock | 51,007 (1) (3) | $ 0 | 0 | I | Endeavour Associates Fund IV, L.P. | |||
Series A Preferred Stock | (2) | 11/19/2008 | C | 477 (1) (2) | (2) | (2) | Common Stock | 871,002 (1) (2) | $ 0 | 0 | I | Endeavour Capital Parallel Fund IV, L.P. | |||
Series C Preferred Stock | (3) | 11/19/2008 | C | 161.48 (1) (3) | (3) | (3) | Common Stock | 94,197 (1) (3) | $ 0 | 0 | I | Endeavour Capital Parallel Fund IV, L.P. |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Dorman D. Mark 920 SW SIXTH AVENUE, SUITE 1400 PORTLAND, OR 97204 |
X | X |
/s/ Lyn Bickle, Attorney-in-Fact | 11/21/2008 | |
**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) | Mr. Dorman is a managing director of Endeavour Capital IV, LLC, which is the general partner of Endeavour Capital Fund IV, L.P., Endeavour Associates Fund IV, L.P. and Endeavour Capital Parallel Fund IV, L.P. Mr. Dorman disclaims beneficial ownership of these shares except to the extent of his respective pecuniary interest. |
(2) | Upon the closing of the initial public offering of the Issuer's Common Stock, the shares of Series A Preferred Stock reported in Column 5 of Table II automatically converted into the number of shares of the Issuer's Common Stock reported in Column 7 of Table II, for no additional consideration. |
(3) | Upon the closing of the initial public offering of the Issuer's Common Stock, the shares of Series C Preferred Stock reported in Column 5 of Table II automatically converted into the number of shares of the Issuer's Common Stock reported in Column 7 of Table II, for no additional consideration. |