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 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 A Preferred Shares | (1) | (2) | Ordinary Shares | 721,408 | $ (1) | D (5) | |
Series B-1 Preferred Shares | (3) | (2) | Ordinary Shares | 275,446 | $ (3) | D (5) | |
Series B-2 Preferred Shares | (4) | (2) | Ordinary Shares | 229,660 | $ (4) | D (5) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Sofinnova Venture Partners IX, L.P. C/O SOFINNOVA VENTURES, INC., 3000 SAND HILL ROAD, BLDG. 4, SUITE 250 MENLO PARK, CA 94025 |
X | |||
POWELL MICHAEL C/O SOFINNOVA VENTURES, INC., 3000 SAND HILL ROAD, BLDG. 4, SUITE 250 MENLO PARK, CA 94025 |
X | |||
Sofinnova Management IX, L.L.C. C/O SOFINNOVA VENTURES, INC., 3000 SAND HILL ROAD, BLDG. 4, SUITE 250 MENLO PARK, CA 94025 |
X | |||
Mehra Anand C/O SOFINNOVA VENTURES, INC., 3000 SAND HILL ROAD, BLDG. 4, SUITE 250 MENLO PARK, CA 94025 |
X |
/s/ Nathalie Auber, Attorney-in-Fact | 05/24/2018 | |
**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) | The Series A Preferred Shares are convertible into Ordinary Shares of the Issuer at the option of the holder. The Series A Preferred Shares will automatically convert into Ordinary Shares of the Issuer on a 1-to-1 basis upon closing of the initial public offering of the Issuer. |
(2) | Not applicable. |
(3) | The Series B-1 Preferred Shares are convertible into Ordinary Shares of the Issuer at the option of the holder. The Series B-1 Preferred Shares will automatically convert into Ordinary Shares of the Issuer on a 1-to-1 basis upon closing of the initial public offering of the Issuer. |
(4) | The Series B-2 Preferred Shares are convertible into Ordinary Shares of the Issuer at the option of the holder. The Series B-2 Preferred Shares will automatically convert into Ordinary Shares of the Issuer on a 1-to-1 basis upon closing of the initial public offering of the Issuer. |
(5) | The shares are held directly by Sofinnova Venture Partners IX, L.P. ("SVP IX"). Sofinnova Management IX, L.L.C. ("SM IX") is the general partner of SVP IX and may be deemed to have sole voting, investment and dispositive power with respect to the shares held by SVP IX. Dr. James I. Healy, Michael F. Powell, Ph.D., and Dr. Anand Mehra are the managing members of SM IX and may be deemed to have shared voting, investment and dispositive power with respect to the shares held by SVP IX. Each of the reporting persons disclaims beneficial ownership of such securities, except to the extent of his, her or its proportionate pecuniary interest therein. |