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
(3)
|
Â
(3)
|
Common Stock
|
2,459,452
|
$
(3)
|
I
|
Directly owned by Pitango Venture Capital Fund IV, L.P. See Explanation of Responses
(1)
(2)
|
Series B Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
53,111
|
$
(3)
|
I
|
Directly owned by Pitango Venture Capital Principals Fund IV, L.P. See Explanation of Responses
(1)
(2)
|
Series C Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
376,499
|
$
(3)
|
I
|
Directly owned by Pitango Venture Capital Fund IV, L.P. See Explanation of Responses
(1)
(2)
|
Series C Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
8,130
|
$
(3)
|
I
|
Directly owned by Pitango Venture Capital Principals Fund IV, L.P. See Explanation of Responses
(1)
(2)
|
Series D Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
334,221
|
$
(3)
|
I
|
Directly owned by Pitango Venture Capital Fund IV, L.P. See Explanation of Responses
(1)
(2)
|
Series D Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
7,217
|
$
(3)
|
I
|
Directly owned by Pitango Venture Capital Principals Fund IV, L.P. See Explanation of Responses
(1)
(2)
|
Series E Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
86,924
|
$
(3)
|
I
|
Directly owned by Pitango Venture Capital Fund IV, L.P. See Explanation of Responses
(1)
(2)
|
Series E Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
1,877
|
$
(3)
|
I
|
Directly owned by Pitango Venture Capital Principals Fund IV, L.P. See Explanation of Responses
(1)
(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) |
The Reporting Person is a General Partner at Pitango Venture Capital Fund IV, L.P. ("PVCF"). Pitango V.C. Fund IV, L.P. is the General Partner of PVCF and Pitango Venture Capital Principals Fund IV, L.P., with its own General Partner being Pitango G.P. Capital Holdings Ltd., an Israeli company, owned indirectly by six individuals. These six individuals share voting and dispositive power of the Isuer's shares but none has sole voting or dispositive power of the Issuer's shares. |
(2) |
The Reporting Person disclaims beneficial ownership of the shares of common stock, except to the extent of such Reporting Person's pecuniary interest therein, if any. |
(3) |
Each share of preferred stock of the Issuer is (i) convertible at any time into shares of the Issuer's common stock on a one-for-one basis, and have no expiration date, and (ii) will automatically convert into shares of the Issuer's common stock immediately prior to the closing of the Issuer's initial public offering. |