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 |
Series A Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
11,764
|
$
(2)
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
09/10/2011 |
Common Stock
|
71,000
|
$
0.59
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
11/18/2013 |
Common Stock
|
100,000
|
$
4.6
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
07/27/2014 |
Common Stock
|
150,000
|
$
4.6
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
05/19/2015 |
Common Stock
|
185,000
|
$
6.38
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
09/22/2015 |
Common Stock
|
100,000
|
$
7.74
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
05/16/2016 |
Common Stock
|
100,000
|
$
9.01
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
05/30/2014 |
Common Stock
|
100,000
|
$
10.28
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
07/24/2015 |
Common Stock
|
125,000
|
$
10.28
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
08/06/2016 |
Common Stock
|
150,000
|
$
9.01
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(3)
|
11/16/2016 |
Common Stock
|
100,000
|
$
19
|
D
|
Â
|
* |
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) |
These securities are preferred stock of the Issuer and do not have an expiration date. These securities will automatically convert into shares of common stock in connection with the Issuer's initial public offering. |
(2) |
Each share of Series A Convertible Preferred Stock will convert automatically into shares of Common Stock on a 1-for-1 basis in connection with the Issuer's initial public offering. |
(3) |
The shares subject to the option vest and become exercisable at a rate of 25% of the shares underlying the option vest on the first anniversary of the date of the vesting commencement date, which is the date of grant, and the remainder of the shares underlying the option vest in equal monthly installments over the remaining 36 months thereafter. |