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 of Derivative Security: 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 |
Warrants (right to buy)
|
(2)
|
09/14/2013 |
Common Stock
|
50,000
|
$
0.01
|
D
|
|
Stock Option (right to buy)
|
(2)
|
09/16/2018 |
Common Stock
|
3,750
|
$
9.64
|
D
|
|
Stock Option (right to buy)
|
(2)
|
11/08/2018 |
Common Stock
|
2,500
|
$
9.64
|
D
|
|
Stock Option (right to buy)
|
(2)
|
12/10/2019 |
Common Stock
|
2,500
|
$
9.64
|
D
|
|
Stock Option (right to buy)
|
(3)
|
12/13/2020 |
Common Stock
|
38,000
|
$
1.8
|
D
|
|
Stock Option (right to buy)
|
(4)
|
12/13/2020 |
Common Stock
|
12,000
|
$
1.8
|
D
|
|
* |
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). |
(1) |
Held jointly with wife. |
(2) |
The shares subject to this warrant are immediately exercisable. |
(3) |
One-third of the shares subject to this option vested on the first anniversary of the grant date, December 13, 2011. The remaining shares subject to this option vest ratably on the second and third anniversaries of the grant date, December 13, 2012 and December 13, 2013. |
(4) |
The shares subject to this option vest ratably on the first, second and third anniversaries of the grant date, December 13, 2011, December 13, 2012 and December 13, 2013, provided that no shares vest until such time as the company closes a target equity financing, which is defined as one or more equity financing transactions that results in cumulative gross proceeds of at least $10 million. |