SEC Form 4
| FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol GLAUKOS Corp [ GKOS ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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| 3. Date of Earliest Transaction (Month/Day/Year) 03/03/2021 | ||||||||||||||||||||||||||
| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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| 1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
| Code | V | Amount | (A) or (D) | Price | ||||||
| Common Stock | 03/03/2021 | J(1) | 300,000 | D | $0.00 | 333,917 | I | InterWest Partners X, LP(3) | ||
| Common Stock | 03/03/2021 | J(1) | 3,000 | A | $0.00 | 3,000 | I | InterWest Management Partners X, LLC(3) | ||
| Common Stock | 03/03/2021 | J(2) | 3,000 | D | $0.00 | 0 | I | InterWest Management Partners X, LLC(3) | ||
| Common Stock | 03/03/2021 | J(2) | 680 | A | $0.00 | 6,394(6) | D | |||
| Common Stock | 3,362 | I | By InterWest Partners IX, LP(4) | |||||||
| Common Stock | 9,085 | I | By InterWest Venture Management Company(5) | |||||||
| Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
| Explanation of Responses: |
| 1. Represents pro rata in-kind distribution by InterWest Partners X, LP ("IP10") without consideration to its limited and general partners in accordance with the terms of the InterWest Partners X, LP Limited Partnership Agreement. Includes 3,000 shares distributed to InterWest Management Partners X, LLC ("IMP10") its general partner. |
| 2. Represents pro rata in-kind distribution by IMP10 without consideration to its members in accordance with the terms of the InterWest Management Partners X, LLC Operating Agreement. Includes 680 shares distributed to the Reporting Person. |
| 3. The shares are owned by IP10. The general partner of IP10 is IMP10. The Reporting Person has shared voting and investment control over shares owned by IP10, and disclaims beneficial ownership of those securities, except to the extent of his pecuniary interest therein. |
| 4. Consists of shares owned by InterWest Partners IX, LP ("IP9"). The Reporting Person is a Managing Director of InterWest Management Partners IX, LLC, the general partner of IP9. The Reporting Person has shared voting and investment control over shares owned by IP9, and disclaims beneficial ownership of those securities, except to the extent of his pecuniary interest therein. |
| 5. Consists of shares owned by InterWest Venture Management Company ("IVMC"). The Reporting Person is an officer, director and shareholder of IVMC and has sole voting and investment control over the shares held by IVMC. |
| 6. Includes 4,880 restricted stock units that have not yet vested or been delivered to the Reporting Person |
| Remarks: |
| /s/ Gilbert H. Kliman by Karen A. Wilson, Power of Attorney | 03/05/2021 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * 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). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| 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 Number. | ||