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) 11/10/2021 | 3. Issuer Name and Ticker or Trading Symbol Weave Communications, Inc. [ WEAV ] | |||||||||||||
| 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 | 2,620 | I | Held by Catalyst Investors IV, L.P.(1) |
| Common Stock | 49,503 | I | Held by Catalyst Investors QP IV, L.P.(1) |
| 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-1 Preferred Stock | (2) | (2) | Common Stock | 538,291 | 0.00 | I | Held by Catalyst Investors IV, L.P.(1) |
| Series B-1 Preferred Stock | (2) | (2) | Common Stock | 10,169,445 | 0.00 | I | Held by Catalyst Investors QP IV, L.P.(1) |
| Series C Preferred Stock | (2) | (2) | Common Stock | 8,474 | 0.00 | I | Held by Catalyst Investors IV, L.P.(1) |
| Series C Preferred Stock | (2) | (2) | Common Stock | 160,089 | 0.00 | I | Held by Catalyst Investors QP IV, L.P.(1) |
| Explanation of Responses: |
| 1. The Reporting Person serves as a partner to Catalyst Investors and shares voting and dispositive power with respect to the shares of common stock and preferred stock. Catalyst Investors Partners IV, L.P. ("CIP IV") serves as the general partner of Catalyst Investors IV, L.P. ("CI IV") and Catalyst Investors QP IV, L.P. ("CI QP IV"). Catalyst Investors Partners IV, L.L.C. ("CIP IV LLC") is the general partner of CIP IV. Brian A, Rich, Eugene L, Wolfson and D. Ryan McNally are managers of the board of CIP IV LLC, and as such maybe deemed to have shared voting and dispositive power with respect to the shares held by CI IV and CI QP IV. |
| 2. Each share of Preferred Stock will be automatically converted into one (1) share of the Issuer's Common Stock, for no additional consideration, immediately prior to the consummation of the Issuer's initial public offering, and has no expiration date. |
| Remarks: |
| Exhibit List: Exhibit 24.1 Power of Attorney |
| /s/ Wendy Harper, as Attorney-in-Fact | 11/10/2021 | |
| ** 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 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. | ||