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, 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. | 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 B Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 3,014,396 (3) | $ (2) | I | By Matrix Partners VIII, L.P. (1) |
Series C Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 1,002,104 (3) | $ (2) | I | By Matrix Partners VIII, L.P. (1) |
Series D Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 236,207 (3) | $ (2) | I | By Matrix Partners VIII, L.P. (1) |
Series E Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 73,046 (3) | $ (2) | I | By Matrix Partners VIII, L.P. (1) |
Series B Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 1,661 (3) | $ (2) | I | By Matrix VIII U.S. Management Co., L.L.C. (1) |
Series C Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 551 (3) | $ (2) | I | By Matrix VIII U.S. Management Co., L.L.C. (1) |
Series D Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 130 (3) | $ (2) | I | By Matrix VIII U.S. Management Co., L.L.C. |
Series E Convertible Preferred Stock | Â (2) | Â (2) | Common Stock | 40 (3) | $ (2) | I | By Matrix VIII U.S. Management Co., L.L.C. (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SKOK DAVID R C/O MATRIX PARTNERS, 101 MAIN STREET, 17TH FLOOR CAMBRIDGE, MA 02142 |
 X |  X |  |  |
/s/ John Kelleher, attorney-in-fact | 10/08/2014 | |
**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) | Mr. Skok is a Managing Member of Matrix VIII U.S. Management Co., L.L.C., which is the general partner of Matrix Partners VIII, L.P. Mr. Skok, by virtue of his management position in Matrix VIII U.S. Management Co., L.L.C., has sole voting and dispositive power with respect to these shares. Mr. Skok disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. |
(2) | The Series B, C, D and E Preferred Stock are each convertible at any time at the option of the holder, and will automatically convert into shares of Common Stock on a 1-for-3 basis upon the closing of the Issuer's initial public offering. The securities have no expiration date. |
(3) | Represents the number of shares of Common Stock issuable upon conversion of the Preferred Stock on the terms specified in footnote 2. |
 Remarks: Exhibit 24.1: Limited Power of Attorney |