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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
POLARIS VENTURE MANAGEMENT CO III LLC 1000 WINTER STREET SUITE 3350 WALTHAM, MA 02451-1215 |
X | |||
POLARIS VENTURE PARTNERS III LP 1000 WINTER STREET SUITE 3350 WALTHAM, MA 02451-1215 |
X | |||
POLARIS VENTURE PARTNERS FOUNDERS FUND III LP 1000 WINTER STREET SUITE 3350 WALTHAM, MA 02451-1215 |
X | |||
POLARIS VENTURE PARTNERS ENTREPRENEURS FUND III LP 1000 WINTER STREET SUITE 3350 WALTHAM, MA 02451-1215 |
X | |||
Arnold Stephen D 1000 WINTER STREET SUITE 3350 WALTHAM, MA 02451-1215 |
X | |||
Flint Jonathan A 1000 WINTER STREET SUITE 3350 WALTHAM, MA 02451-1215 |
X | |||
MCGUIRE TERRANCE 1000 WINTER STREET SUITE 3350 WALTHAM, MA 02451-1215 |
X | |||
SPOON ALAN G 1000 WINTER STREET SUITE 3350 WALTHAM, MA 02451-1215 |
X |
/s/ Kevin Littlejohn, Authorized Signatory | 06/29/2005 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Pro-rata distribution in kind without consideration to the general and limited partners of Polaris Venture Partners III, L.P. , a partnership ("PVP III") of which the Designated Filer, Polaris Venture Management Co. III, L.L.C. ("PVM III"), is the general partner. PVM III disclaims beneficial ownership of shares held by PVP III except to the extent of any pecuniary interest therein. |
(2) | Pro-rata distribution in kind without consideration to the general and limited partners of Polaris Venture Partners Entrepreneurs' Fund III, L.P., a partnership ("PVPEF III") of which the Designated Filer, PVM III, is the general partner. PVM III disclaims beneficial ownership of shares held by PVPEF III except to the extent of any pecuniary interest therein. |
(3) | N/A |
(4) | Jonathan A. Flint, Terrance G. McGuire, Alan G. Spoon and Stephen D. Arnold, the managing members of the Designated Filer, PVM III, may be deemed to share voting and dispositive power over shares held by PVM III. Such persons disclaim beneficial ownership of shares held by PVM III except to the extent of any indirect pecuniary interest therein. |
(5) | Pro-rata distribution in kind without consideration to the general and limited partners of Polaris Venture Partners Founders' Fund III, L.P., a partnership ("PVPFF III") of which PVM III is the general partner. PVM III disclaims beneficial ownership of shares held by PVPFF III except to the extent of any pecuniary interest therein. |
(6) | These shares are owned directly by Stephen D. Arnold. |
(7) | These shares are owned directly by Jonathan A. Flint. |