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) 06/30/2015 | ||||||||||||||||||||||||||
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 | 06/30/2015 | C | 2,868,959 | A | (1) | 2,868,959 | I | Through Versant Venture Capital I, L.P.(3) | ||
Common Stock | 06/30/2015 | M(2) | 27,612 | A | (1) | 2,896,571 | I | Through Versant Venture Capital I, L.P.(3) | ||
Common Stock | 06/30/2015 | F(2) | 11,736 | D | $18 | 2,884,835 | I | Through Versant Venture Capital I, L.P.(3) | ||
Common Stock | 06/30/2015 | C | 61,886 | A | (1) | 61,886 | I | Through Versant Affiliates Fund I-A, L.P.(4) | ||
Common Stock | 06/30/2015 | M(2) | 577 | A | (1) | 62,463 | I | Through Versant Affiliates Fund I-A, L.P.(4) | ||
Common Stock | 06/30/2015 | F(2) | 246 | D | $18 | 62,217 | I | Through Versant Affiliates Fund I-A, L.P.(4) | ||
Common Stock | 06/30/2015 | C | 131,738 | A | (1) | 131,738 | I | Through Versant Affiliates Fund I-B L.P.(5) | ||
Common Stock | 06/30/2015 | M(2) | 1,296 | A | (1) | 133,034 | I | Through Versant Affiliates Fund I-B L.P.(5) | ||
Common Stock | 06/30/2015 | F(2) | 551 | D | $18 | 132,483 | I | Through Versant Affiliates Fund I-B L.P.(5) | ||
Common Stock | 06/30/2015 | C | 56,379 | A | (1) | 56,379 | I | Through Versant Side Fund I, L.P.(6) | ||
Common Stock | 06/30/2015 | M(2) | 552 | A | (1) | 56,931 | I | Through Versant Side Fund I, L.P.(6) | ||
Common Stock | 06/30/2015 | F(2) | 235 | D | $18 | 56,696 | I | Through Versant Side Fund I, L.P.(6) |
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 | ||||||||
Series A Convertible Preferred Stock | (1) | 06/30/2015 | C | 552,000 | (1) | (1) | Common Stock | 552,000 | $0(1) | 0 | I | Through Versant Venture Capital I, L.P.(3) | |||
Series A Convertible Preferred Stock | (1) | 06/30/2015 | C | 12,000 | (1) | (1) | Common Stock | 12,000 | $0(1) | 0 | I | Through Versant Affiliates Fund I-A, L.P.(4) | |||
Series A Convertible Preferred Stock | (1) | 06/30/2015 | C | 25,200 | (1) | (1) | Common Stock | 25,200 | $0(1) | 0 | I | Through Versant Affiliates Fund I-B L.P.(5) | |||
Series A Convertible Preferred Stock | (1) | 06/30/2015 | C | 10,800 | (1) | (1) | Common Stock | 10,800 | $0(1) | 0 | I | Through Versant Side Fund I, L.P.(6) | |||
Series B Convertible Preferred Stock | (1) | 06/30/2015 | C | 851,852 | (1) | (1) | Common Stock | 851,852 | $0(1) | 0 | I | Through Versant Venture Capital I, L.P.(3) | |||
Series B Convertible Preferred Stock | (1) | 06/30/2015 | C | 18,518 | (1) | (1) | Common Stock | 18,518 | $0(1) | 0 | I | Through Versant Affiliates Fund I-A, L.P.(4) | |||
Series B Convertible Preferred Stock | (1) | 06/30/2015 | C | 38,888 | (1) | (1) | Common Stock | 38,888 | $0(1) | 0 | I | Through Versant Affiliates Fund I-B L.P.(5) | |||
Series B Convertible Preferred Stock | (1) | 06/30/2015 | C | 16,666 | (1) | (1) | Common Stock | 16,666 | $0(1) | 0 | I | Through Versant Side Fund I, L.P.(6) | |||
Series C Convertible Preferred Stock | (1) | 06/30/2015 | C | 479,714 | (1) | (1) | Common Stock | 479,714 | $0(1) | 0 | I | Through Versant Venture Capital I, L.P.(3) | |||
Series C Convertible Preferred Stock | (1) | 06/30/2015 | C | 10,428 | (1) | (1) | Common Stock | 10,428 | $0(1) | 0 | I | Through Versant Affiliates Fund I-A, L.P.(4) | |||
Series C Convertible Preferred Stock | (1) | 06/30/2015 | C | 21,900 | (1) | (1) | Common Stock | 21,900 | $0(1) | 0 | I | Through Versant Affiliates Fund I-B L.P.(5) | |||
Series C Convertible Preferred Stock | (1) | 06/30/2015 | C | 9,386 | (1) | (1) | Common Stock | 9,386 | $0(1) | 0 | I | Through Versant Side Fund I, L.P.(6) | |||
Series D Convertible Preferred Stock | (1) | 06/30/2015 | C | 548,464 | (1) | (1) | Common Stock | 548,464 | $0(1) | 0 | I | Through Versant Venture Capital I, L.P.(3) | |||
Series D Convertible Preferred Stock | (1) | 06/30/2015 | C | 11,805 | (1) | (1) | Common Stock | 11,805 | $0(1) | 0 | I | Through Versant Affiliates Fund I-A, L.P.(4) | |||
Series D Convertible Preferred Stock | (1) | 06/30/2015 | C | 25,226 | (1) | (1) | Common Stock | 25,226 | $0(1) | 0 | I | Through Versant Affiliates Fund I-B L.P.(5) | |||
Series D Convertible Preferred Stock | (1) | 06/30/2015 | C | 10,791 | (1) | (1) | Common Stock | 10,791 | $0(1) | 0 | I | Through Versant Side Fund I, L.P.(6) | |||
Series E Convertible Preferred Stock | (1) | 06/30/2015 | C | 163,592 | (1) | (1) | Common Stock | 163,592 | $0(1) | 0 | I | Through Versant Venture Capital I, L.P.(3) | |||
Series E Convertible Preferred Stock | (1) | 06/30/2015 | C | 3,420 | (1) | (1) | Common Stock | 3,420 | $0(1) | 0 | I | Through Versant Affiliates Fund I-A, L.P.(4) | |||
Series E Convertible Preferred Stock | (1) | 06/30/2015 | C | 7,684 | (1) | (1) | Common Stock | 7,684 | $0(1) | 0 | I | Through Versant Affiliates Fund I-B L.P.(5) | |||
Series E Convertible Preferred Stock | (1) | 06/30/2015 | C | 3,271 | (1) | (1) | Common Stock | 3,271 | $0(1) | 0 | I | Through Versant Side Fund I, L.P.(6) | |||
Series F Convertible Preferred Stock | (1) | 06/30/2015 | C | 273,337 | (1) | (1) | Common Stock | 273,337 | $0(1) | 0 | I | Through Versant Venture Capital I, L.P.(3) | |||
Series F Convertible Preferred Stock | (1) | 06/30/2015 | C | 5,715 | (1) | (1) | Common Stock | 5,715 | $0(1) | 0 | I | Through Versant Affiliates Fund I-A, L.P.(4) | |||
Series F Convertible Preferred Stock | (1) | 06/30/2015 | C | 12,840 | (1) | (1) | Common Stock | 12,840 | $0(1) | 0 | I | Through Versant Affiliates Fund I-B L.P.(5) | |||
Series F Convertible Preferred Stock | (1) | 06/30/2015 | C | 5,465 | (1) | (1) | Common Stock | 5,465 | $0(1) | 0 | I | Through Versant Side Fund I, L.P.(6) | |||
Series D Convertible Preferred Stock Warrant (right to buy) | $7.65 | 06/30/2015 | M | 27,612 | (2) | (2) | Common Stock | 27,612 | $0(2) | 0 | I | Through Versant Venture Capital I, L.P.(3) | |||
Series D Convertible Preferred Stock Warrant (right to buy) | $7.65 | 06/30/2015 | M | 577 | (2) | (2) | Common Stock | 577 | $0(2) | 0 | I | Through Versant Affiliates Fund I-A,, L.P.(4) | |||
Series D Convertible Preferred Stock Warrant (right to buy) | $7.65 | 06/30/2015 | M | 1,296 | (2) | (2) | Common Stock | 1,296 | $0(2) | 0 | I | Through Versant Affiliates Fund I-B L.P.(5) | |||
Series D Convertible Preferred Stock Warrant (right to buy) | $7.65 | 06/30/2015 | M | 552 | (2) | (2) | Common Stock | 552 | $0(2) | 0 | I | Through Versant Side Fund I, L.P.(6) |
Explanation of Responses: |
1. The shares of Series A Convertible Preferred Stock, Series B Convertible Preferred Stock, Series C Convertible Preferred Stock, Series D Convertible Preferred Stock, Series E Convertible Preferred Stock and Series F Convertible Preferred Stock automatically converted into shares of common stock on a 1:1 basis immediately prior to the consummation of the Issuer's initial public offering ("IPO") and had no expiration date. |
2. The warrants to acquire Series D Convertible Preferred Stock automatically net exercised immediately prior to consummation of the IPO at the IPO price per share and the shares of Series D Convertible Preferred Stock received thereupon automatically converted into shares of common stock as described in footnote (1). |
3. The shares are held by Versant Venture Capital I, L.P., a Delaware limited partnership ("VVC I"). Versant Ventures I, LLC, a Delaware limited liability company (''VV I'') serves as the sole general partner of VVC I. William J. Link, Ph.D is a director and/or member of VV I and shares voting and dispositive power over the shares held by VVC I; however, he disclaims beneficial ownership of the shares held by such entities except to the extent of his pecuniary interests therein. |
4. The shares are held by Versant Affiliates Fund I-A, L.P., a Delaware limited partnership (''VAF I-A''). VV I serves as the sole general partner of VAF I-A. William J. Link, Ph.D is a director and/or member of VV I and shares voting and dispositive power over the shares held by VAF I-A; however, he disclaims beneficial ownership of the shares held by such entities except to the extent of pecuniary interests therein. |
5. The shares are held by Versant Affiliates Fund I-B, L.P., a Delaware limited partnership (''VAF I-B''). VV I serves as the sole general partner of VAF I-B. William J. Link, Ph.D.,is a director and/or member of VV I and shares voting and dispositive power over the shares held by VAF I-B; however, he disclaims beneficial ownership of the shares held by such entities except to the extent of his pecuniary interests therein. |
6. The shares are held by Versant Side Fund I, L.P., a Delaware limited partnership (''VSF I''). William J. Link, Ph.D. is a director and/or member of VV I and shares voting and dispositive power over the shares held by VSF I; however, he disclaims beneficial ownership of the shares held by such entities except to the extent of his pecuniary interests therein. |
/s/ Richard L. Harrison, Attorney-in-Fact | 06/30/2015 | |
** 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. | ||
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