SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 10/30/2019 | 3. Issuer Name and Ticker or Trading Symbol Oyster Point Pharma, Inc. [ OYST ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. 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 Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock, par value $0.001 per share | 2,018 | I | See footnotes(1)(3) |
Common Stock, par value $0.001 per share | 320,439 | I | See footnotes(2)(3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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: 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 A Convertible Preferred Stock | (4) | (4) | Common Stock, par value $0.001 per share | 10,420 | (4) | I | See footnotes(1)(3) |
Series A Convertible Preferred Stock | (4) | (4) | Common Stock, par value $0.001 per share | 1,654,359 | (4) | I | See footnotes(2)(3) |
Series B Convertible Preferred Stock | (4) | (4) | Common Stock, par value $0.001 per share | 955,392 | (4) | I | See footnotes(5) |
Explanation of Responses: |
1. Shares held by Versant Side Fund IV, L.P. ("Versant Side Fund IV"). |
2. Shares held by Versant Venture Capital IV, L.P. ("Versant IV"). |
3. The Reporting Person may be deemed to beneficially own the shares indirectly by reason of the Reporting Person is a managing member of Versant Ventures IV, LLC, the sole general partner of Versant IV and Versant Side Fund IV. The Reporting Person disclaims beneficial ownership of the securities reported herein except to the extent of his pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person, as applicable, is the beneficial owner of, or has any pecuniary interest in, such securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose. |
4. These shares of Series A Convertible Preferred Stock and Series B Convertible Preferred Stock (collectively, "Preferred Stock") will automatically be converted into shares of Issuer's common stock, $0.001 par value per share ("Common Stock"), on a one-for-one basis, immediately prior to the completion of the Issuer's initial public offering. The Preferred Stock has no expiration date. |
5. Shares held by Oyster Point Pharma I, L.L.C. The Reporting Person may be deemed to beneficially own the shares indirectly by reason of the Reporting Person as the controlling member of Oyster Point Pharma I, L.L.C. |
Remarks: |
Exhibit 24 - Power of Attorney |
/s/Jeffrey Nau, Attorney-in-fact | 10/30/2019 | |
** 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 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). | ||
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. |