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-1 Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
628,399
|
$
(1)
|
I
|
See footnotes
(2)
|
Series B-1 Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
137,326
|
$
(3)
|
I
|
See footnotes
(2)
|
Series B-2 Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
254,834
|
$
(3)
|
I
|
See footnotes
(2)
|
Series B-3 Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
122,107
|
$
(3)
|
I
|
See footnotes
(2)
|
Series B-1 Warrant (Right to Buy)
|
Â
(3)(4)
|
05/02/2017 |
Series B-1 Convertible Preferred Stock
|
312,228
(3)
|
$
0.1297
|
I
|
See footnotes
(2)
|
Stock Option (Right to Buy)
|
Â
(5)
|
03/26/2024 |
Common Stock
|
9,375
|
$
12
|
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) |
Each share of Series A-1 convertible preferred stock is convertible into shares of common stock at any time at the holder's election or upon consummation of a qualified public offering of the registrant on an approximately 1-for-16.62 basis. The Series A-1 convertible preferred stock has no expiration date. |
(2) |
Held of record by Intersouth Partners VI, L.P. Intersouth Associates VI, LLC is the general partner of Intersouth Partners VI, L.P. The reporting person is a Partner at Intersouth Associates VI, LLC. The reporting person disclaims beneficial ownership of all the shares held by Intersouth Partners VI, L.P. and this report shall not be deemed an admission of beneficial ownership of such shares for the purposes of Section 16 or for any other purpose except to the extent of his proportionate pecuniary interest therein. |
(3) |
Each share of Series B-1, B-2 and B3 convertible preferred stock is convertible into shares of common stock at any time at the holder's election or upon the consummation of a qualified public offering of the registrant on a 1-for-35 basis. The Series B-1, B-2 and B-3 convertible preferred stock has no expiration date. |
(4) |
The Series B-1 Warrant is exercisable for shares of Series B-1 convertible preferred stock at any time until the expiration of the warrant at the holder's election. |
(5) |
Option becomes exercisable in equal yearly installments over three years from the date of grant. |