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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 B Preferred Stock | (1) | 10/03/2012 | C | 1,016,185 | (1) | (1) | Common Stock | 1,016,185 | $ 0 | 0 | D | ||||
Series B Preferred Stock | (1) | 10/03/2012 | C | 353,045 | (1) | (1) | Common Stock | 353,045 | $ 0 | 0 | I | By GRPVC, L.P. (1) | |||
Series B Preferred Stock | (1) | 10/03/2012 | C | 123,076 | (1) | (1) | Common Stock | 123,076 | $ 0 | 0 | I | By GRP II Investors, L.P. (1) | |||
Series B Preferred Stock | (1) | 10/03/2012 | C | 46,153 | (1) | (1) | Common Stock | 46,153 | $ 0 | 0 | I | By GRP II Partners, L.P. (1) | |||
Series C Preferred Stock | (1) | 10/03/2012 | C | 641,538 | (1) | (1) | Common Stock | 641,538 | $ 0 | 0 | D | ||||
Series C Preferred Stock | (1) | 10/03/2012 | C | 222,884 | (1) | (1) | Common Stock | 222,884 | $ 0 | 0 | I | By GRPVC, L.P. (1) | |||
Series C Preferred Stock | (1) | 10/03/2012 | C | 77,700 | (1) | (1) | Common Stock | 77,700 | $ 0 | 0 | I | By GRP II Investors, L.P (1) | |||
Series C Preferred Stock | (1) | 10/03/2012 | C | 29,136 | (1) | (1) | Common Stock | 29,136 | $ 0 | 0 | I | By GRP II Partners, L.P. (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
AOS Partners, LP 2121 AVENUE OF THE STARS, SUITE 1630 LOS ANGELES, CA 90067 |
X | |||
GRPVC, L.P. 2121 AVENUE OF THE STARS, SUITE 1630 LOS ANGELES, CA 90067 |
X | |||
GRP II Investors, L.P. 2121 AVENUE OF THE STARS, SUITE 1630 LOS ANGELES, CA 90067 |
X | |||
GRP II Partners, L.P. 2121 AVENUE OF THE STARS, SUITE 1630 LOS ANGELES, CA 90067 |
X |
/s/ Dana Kibler, for Hique, Inc., the General Partner of AOS Partners, L.P. | 10/03/2012 | |
**Signature of Reporting Person | Date | |
/s/ Dana Kibler, for GRP Management Services Corp., the General Partner of GRPVC, L.P. | 10/03/2012 | |
**Signature of Reporting Person | Date | |
/s/ Dana Kibler, for GRP Management Services Corp., the General Partner of GRP II Investors, L.P. | 10/03/2012 | |
**Signature of Reporting Person | Date | |
/s/ Dana Kibler, for GRPVC, L.P., the General Partner of GRP II Partners, 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 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. |