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) 06/29/2017 | 3. Issuer Name and Ticker or Trading Symbol Tintri, Inc. [ TNTR ] | |||||||||||||
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) |
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 B Preferred Stock | (1) | (1) | Common Stock | 1,306,484 | 0.00 | D(2)(3) | |
Series C Preferred Stock | (4) | (4) | Common Stock | 580,800 | 0.00 | D(2)(3) | |
Series D Preferred Stock | (5) | (5) | Common Stock | 217,477 | 0.00 | D(2)(3) | |
Series E-2 Preferred Stock | (6) | (6) | Common Stock | 208,331(7) | 0.00(6) | D(2)(3) | |
Series E-1 Preferred Stock | (8) | (8) | Common Stock | 83,333(9) | 0.00(8) | D(2)(3) | |
Series F-2 Preferred Stock | (10) | (10) | Common Stock | 113,533(11) | 0.00(10) | D(2)(3) | |
Stock Purchase Warrant (right to buy) | (12) | 06/01/2027 | Common Stock | 516,137(12) | 16.44 | D(2)(3) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. The Series B Preferred Stock is, at the option of the holder, convertible into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series B Preferred Stock does not have an expiration date. |
2. Shares held by Lightspeed Venture Partners VIII, L.P. ("LVP VIII"). |
3. Lightspeed Ultimate General Partner VIII, Ltd. ("LUGP VIII") is the sole general partner of Lightspeed General Partner VIII, L.P., which serves as the sole general partner of LVP VIII. Barry Eggers, Ravi Mhatre, Peter Y. Nieh and Christopher J. Schaepe, the directors of LUGP VIII, share voting and dispositive power with respect to the shares held of record by LVP VIII. Each reporting person disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein. |
4. The Series C Preferred Stock is, at the option of the holder, convertible into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series C Preferred Stock does not have an expiration date. |
5. The Series D Preferred Stock is, at the option of the holder, convertible into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series D Preferred Stock does not have an expiration date. |
6. The Series E-2 Preferred Stock is, at the option of the holder, convertible into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1.68214-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series E-2 Preferred Stock does not have an expiration date. |
7. The number of shares of Common Stock reported in the table reflect a conversion on a 1-for-1 basis. The Series E-2 Preferred Stock held by LVP VIII will convert into a total of 350,441 shares of Common Stock in connection with the Issuer's initial public offering. |
8. The Series E-1 Preferred Stock is, at the option of the holder, convertible into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1.68214-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series E-1 Preferred Stock does not have an expiration date. |
9. The number of shares of Common Stock reported in the table reflect a conversion on a 1-for-1 basis. The Series E-1 Preferred Stock held by LVP VIII will convert into a total of 140,177 shares of Common Stock in connection with the Issuer's initial public offering. |
10. The Series F-2 Preferred Stock is, at the option of the holder, convertible into shares of Common Stock on a 1-for-1 basis and will automatically convert into shares of Common Stock on a 1.68214-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series F-2 Preferred Stock does not have an expiration date. |
11. The number of shares of Common Stock reported in the table reflect a conversion on a 1-for-1 basis. The Series F-2 Preferred Stock held by LVP VIII will convert into a total of 190,978 shares of Common Stock in connection with the Issuer's initial public offering. |
12. The warrant to purchase Common Stock will become exercisable upon closing of the Issuer's initial public offering. |
Remarks: |
Mr. Schaepe is a director of the Issuer and files a separate report on Form 3 with respect to his beneficial ownership of Issuer securities held by LVP VIII. |
LIGHTSPEED VENTURE PARTNERS VIII, L.P., By: /s/ Christopher Schaepe, director of Lightspeed Ultimate General Partner VIII, Ltd., the sole general partner of Lightspeed General Partner VIII, L.P., | 06/29/2017 | |
the sole general partner of Lightspeed Venture Partners VIII, L.P. | 06/29/2017 | |
/s/ Barry Eggers | 06/29/2017 | |
/s/ Peter Nieh | 06/29/2017 | |
/s/ Ravi Mhatre | 06/29/2017 | |
** 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. |