UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(AMENDMENT NO. ________________)*
NEUROMETRIX, INC.
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(Name of Issuer)
COMMON STOCK, $.0001 PAR VALUE
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(Title of Class of Securities)
641255104
-------------------
(CUSIP Number)
DECEMBER 31, 2004
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(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule
is filed:
|_| Rule 13d-1(b)
|_| Rule 13d-1(c)
|X| Rule 13d-1(d)
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
Page 1 of 13 pages
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CUSIP NO. 641255104 13G PAGE 2 OF 14 PAGES
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1 NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
Commonwealth Capital Ventures II L.P.
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
(a) |_|
(b) |_|
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware Limited Partnership
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5 SOLE VOTING POWER
NUMBER OF
SHARES 0 shares
BENEFICIALLY ------------------------------------------------------------
OWNED BY 6 SHARED VOTING POWER
EACH
REPORTING 718,215 shares
PERSON ------------------------------------------------------------
WITH 7 SOLE DISPOSITIVE POWER
0 shares
------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
718,215 shares
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
718,215
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS) |_|
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11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
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12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
PN
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Page 2 of 13 pages
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CUSIP NO. 641255104 13G PAGE 3 OF 14 PAGES
-------------------------------- ------------------------------------
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1 NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
CCV II Associates L.P.
--------------------------------------------------------------------------------
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
(a) |_|
(b) |_|
--------------------------------------------------------------------------------
3 SEC USE ONLY
--------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware Limited Partnership
--------------------------------------------------------------------------------
5 SOLE VOTING POWER
NUMBER OF
SHARES 0 shares
BENEFICIALLY --------------------------------------------------------------
OWNED BY 6 SHARED VOTING POWER
EACH
REPORTING 718,215 shares
PERSON --------------------------------------------------------------
WITH: 7 SOLE DISPOSITIVE POWER
0 shares
--------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
718,215 shares
--------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
718,215 shares
--------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS) |_|
--------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
--------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
PN
--------------------------------------------------------------------------------
Page 3 of 13 pages
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CUSIP NO. 641255104 13G PAGE 4 OF 14 PAGES
-------------------------------- ------------------------------------
--------------------------------------------------------------------------------
1 NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
Commonwealth Venture Partners II L.P.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
(a) |_|
(b) |_|
--------------------------------------------------------------------------------
3 SEC USE ONLY
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware Limited Partnership
5 SOLE VOTING POWER
NUMBER OF
SHARES 0 shares
BENEFICIALLY ------------------------------------------------------------
OWNED BY 6 SHARED VOTING POWER
EACH
REPORTING 718,215 shares
PERSON ------------------------------------------------------------
WITH 7 SOLE DISPOSITIVE POWER
0 shares
------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
718,215 shares
--------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
718,215 shares
--------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES
(SEE INSTRUCTIONS) |_|
--------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
--------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
PN
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Page 4 of 13 pages
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CUSIP NO. 641255104 13G PAGE 5 OF 14 PAGES
-------------------------------- ------------------------------------
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1 NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
Michael T. Fitzgerald
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
(a) |_|
(b) |_|
--------------------------------------------------------------------------------
3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
--------------------------------------------------------------------------------
5 SOLE VOTING POWER
NUMBER OF
SHARES 0 shares
BENEFICIALLY ------------------------------------------------------------
OWNED BY 6 SHARED VOTING POWER
EACH
REPORTING 718,215 shares
PERSON ------------------------------------------------------------
WITH 7 SOLE DISPOSITIVE POWER
0 shares
------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
718,215 shares
--------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
718,215 shares
--------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS)
|_|
--------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
--------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN
--------------------------------------------------------------------------------
Page 5 of 13 pages
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CUSIP NO. 641255104 13G PAGE 6 OF 14 PAGES
-------------------------------- ------------------------------------
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1 NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
Jeffrey M. Hurst
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
(a) |_|
(b) |_|
--------------------------------------------------------------------------------
3 SEC USE ONLY
--------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
--------------------------------------------------------------------------------
5 SOLE VOTING POWER
NUMBER OF
SHARES 0 shares
BENEFICIALLY ------------------------------------------------------------
OWNED BY 6 SHARED VOTING POWER
EACH
REPORTING 718,215 shares
PERSON ------------------------------------------------------------
WITH 7 SOLE DISPOSITIVE POWER
0 shares
------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
718,215 shares
--------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
718,215 shares
--------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES
(SEE INSTRUCTIONS) |_|
--------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
--------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN
--------------------------------------------------------------------------------
Page 6 of 13 pages
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CUSIP NO. 641255104 13G PAGE 7 OF 14 PAGES
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1 NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
R. Stephen McCormack, Jr.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
(a) |_|
(b) |_|
--------------------------------------------------------------------------------
3 SEC USE ONLY
--------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
--------------------------------------------------------------------------------
5 SOLE VOTING POWER
NUMBER OF
SHARES 0 shares
BENEFICIALLY ------------------------------------------------------------
OWNED BY 6 SHARED VOTING POWER
EACH
REPORTING 718,215 shares
PERSON ------------------------------------------------------------
WITH 7 SOLE DISPOSITIVE POWER
0 shares
------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
718,215 shares
--------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
718,215 shares
--------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS) |_|
--------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
--------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN
--------------------------------------------------------------------------------
Page 7 of 13 pages
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CUSIP NO. 641255104 13G PAGE 7 OF 14 PAGES
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1 NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
Justin Perreault
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--------------------------------------------------------------------------------
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
(a) |_|
(b) |_|
--------------------------------------------------------------------------------
3 SEC USE ONLY
--------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
--------------------------------------------------------------------------------
5 SOLE VOTING POWER
NUMBER OF
SHARES 0 shares
BENEFICIALLY ------------------------------------------------------------
OWNED BY 6 SHARED VOTING POWER
EACH
REPORTING 718,215 shares
PERSON ------------------------------------------------------------
WITH 7 SOLE DISPOSITIVE POWER
0 shares
------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
718,215 shares
--------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
718,215 shares
--------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS)
--------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
--------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN
--------------------------------------------------------------------------------
Page 8 of 13 pages
SCHEDULE 13G
Item 1(a). NAME OF ISSUER: Neurometrix, Inc. (the "Issuer").
Item 1(b). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES:
62 Fourth Avenue, Waltham, MA 02451
Item 2(a). NAMES OF PERSONS FILING: Commonwealth Venture Partners II L.P.,
Commonwealth Capital Ventures II L.P., and CCV II Associates, L.P.
(together, the "Entities") and Michael T. Fitzgerald, Jeffrey M.
Hurst, R. Stephen McCormack, Jr. and Justin Perreault (together, the
"Individuals" and together with the Entities, the "Reporting
Persons").
Commonwealth Venture Partners II L.P. is the sole general partner of
Commonwealth Capital Ventures II L.P. and CCV II Associates, L.P.
The Individuals are the individual general partners of Commonwealth
Venture Partners II L.P.
Item 2(b). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE: The
address of the principal business office of each of the Reporting
Persons is Bay Colony Corporate Center, 950 Winter St., Suite 4100,
Waltham, MA 02451.
Item 2(c). CITIZENSHIP: Each Entity a limited partnership organized under the
laws of the State of Delaware. Each Individual is a citizen of the
United States.
Item 2(d). TITLE OF CLASS OF SECURITIES: Common Stock, $.0001 par value
("Common Stock").
Item 2(e). CUSIP NUMBER: 641255104
Item 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13D-1(B), OR 13D-2(B)
OR (C), CHECK WHETHER THE PERSON FILING IS A:
Not Applicable.
Item 4. Ownership.
(a) Amount Beneficially Owned:
As of December 31, 2004, Commonwealth Capital Ventures II L.P. is
the record owner of 684,382 shares of Common Stock and CCV II
Associates, L.P. is the record owner of 33,833 shares of Common
Stock (referred to collectively as the "Record Shares"). By virtue
of the affiliate relationships among the Reporting Persons, each
Reporting Person may be deemed to own beneficially all of the Record
Shares. Hence, each Reporting Person may be deemed to own
beneficially 718,215 shares of Common Stock.
(b) Percent of Class:
Each Reporting Person may be deemed to own beneficially 6.0% of the
12,025,119 shares of Common Stock outstanding as of November 9, 2004
as reported on the Issuer's Form 10-Q for the quarter ending
September 30, 2004.
(c) Number of shares as to which such person has:
(i) sole power to vote or to direct the vote: See cover sheets.
Page 9 of 13 pages
(ii) shared power to vote or to direct the vote: See cover sheets.
(iii) sole power to dispose or to direct the disposition of: See
cover sheets.
(iv) shared power to dispose or to direct the disposition of: See
cover sheets.
Each Reporting Person disclaims beneficial ownership of such shares of
Common Stock or options to purchase Common Stock except for those shares
or options, if any, such Reporting Person holds of record.
Item 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS.
Not Applicable.
Item 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER
PERSON.
Not Applicable.
Item 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH
ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING
COMPANY.
Not Applicable.
Item 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP.
Not Applicable. The reporting persons expressly disclaim
membership in a "group" as defined in Rule 13d-5(b).
Item 9. NOTICE OF DISSOLUTION OF GROUP.
Not Applicable.
Item 10. CERTIFICATIONS.
Not Applicable. This statement on Schedule 13G is not filed
pursuant to Rule 13d-1(b) or Rule 13d-1(c).
[REMAINDER OF PAGE LEFT BLANK INTENTIONALLY]
[SIGNATURE PAGE FOLLOWS IMMEDIATELY]
SIGNATURES
After reasonable inquiry and to the best of his knowledge and belief, each
of the undersigned certifies that the information set forth in this statement is
true, complete and correct. Each of the undersigned also hereby agrees to file
this statement jointly pursuant to the Agreement listed on EXHIBIT 1 hereto.
Dated: February 1, 2005
CCV II ASSOCIATES L.P.
By: Commonwealth Venture Partners II L.P. *
---------------------------------
Michael T. Fitzgerald
By: * *
----------------------------- ---------------------------------
Michael T. Fitzgerald Jeffrey M. Hurst
General Partner
COMMONWEALTH CAPITAL VENTURES II L.P. *
---------------------------------
By: Commonwealth Venture Partners II L.P. R. Stephen McCormack, Jr.
By: * *
--------------------------------- ----------------------------------
Michael T. Fitzgerald Justin Perreault
General Partner
COMMONWEALTH VENTURE PARTNERS II L.P.
By: *
-----------------------------
Michael T. Fitzgerald
General Partner
* The undersigned attorney-in-fact, by signing his name below, does hereby
sign this statement on behalf of himself and the other above indicated
filers pursuant to Powers of Attorney which are attached hereto as Exhibit
2 and incorporated herein by reference.
/S/ JEFFREY M. HURST
-----------------------------------
Individually and as Attorney-in-fact
Page 11 of 13 pages
EXHIBIT 1
AGREEMENT
Pursuant to Rule 13d-1(k)(1) under the Securities Exchange Act of 1934, the
undersigned hereby agree that only one statement containing the information
required by Schedule 13G need be filed with respect to the ownership by each of
the undersigned of shares of Common Stock of Neurometrix, Inc.
This agreement may be executed in any number of counterparts, each of which
shall be deemed an original.
EXECUTED this 1st day of February, 2005.
CCV II ASSOCIATES L.P.
By: Commonwealth Venture Partners II L.P. *
---------------------------------
Michael T. Fitzgerald
By: * *
----------------------------- ---------------------------------
Michael T. Fitzgerald Jeffrey M. Hurst
General Partner
COMMONWEALTH CAPITAL VENTURES II L.P. *
---------------------------------
By: Commonwealth Venture Partners II L.P. R. Stephen McCormack, Jr.
By: * *
--------------------------------- ----------------------------------
Michael T. Fitzgerald Justin Perreault
General Partner
COMMONWEALTH VENTURE PARTNERS II L.P.
By: *
-----------------------------
Michael T. Fitzgerald
General Partner
* The undersigned attorney-in-fact, by signing his name below, does hereby sign
this statement on behalf of himself and the other above indicated filers
pursuant to Powers of Attorney which are attached hereto as EXHIBIT 2 AND
INCORPORATED HEREIN BY REFERENCE.
/S/ JEFFREY M. HURST
------------------------------------
Individually and as Attorney-in-fact
Page 12 of 13 pages
EXHIBIT 2
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that each person whose signature appears
below hereby constitutes and appoints each and any of Michael T. Fitzgerald,
Jeffery M. Hurst, R. Stephen McCormack, Jr. and Justin Perreault his true and
lawful attorney-in-fact and agent, with full power of substitution and
resubstitution, for him and in his name, place and stead, in any and all
capacities (until revoked in writing) to sign any and all instruments,
certificates and documents required to be executed on behalf of himself
individually or on behalf of each or any of Commonwealth Capital Ventures II
L.P., CCV II Associates L.P. and Commonwealth Venture Partners II L.P. pursuant
to sections 13 and 16 of the Securities Exchange Act of 1934, as amended (the
"Exchange Act"), and any and all regulations promulgated thereunder, and to file
the same, with all exhibits thereto, and any other documents in connection
therewith, with the Securities and Exchange Commission, and with any other
entity when and if such is mandated by the Exchange Act or by the By-laws of the
National Association of Securities Dealers, granting unto said attorney-in-fact
and agent full power and authority to do and perform each and every act and
thing requisite and necessary fully to all intents and purposes as he might or
could do in person thereby ratifying and confirming all that said
attorney-in-fact and agent, or his substitute or substitutes, may lawfully do or
cause to be done by virtue hereof.
IN WITNESS WHEREOF, this Power of Attorney has been signed as of the 1st
day of February, 2005.
/s/ Michael T. Fitzgerald
--------------------------------------------
Michael T. Fitzgerald
/s/ Jeffrey M. Hurst
--------------------------------------------
Jeffrey M. Hurst
/s/ R. Stephen McCormack, jr.
--------------------------------------------
R. Stephen McCormack, Jr.
/s/ Justin Perreault
--------------------------------------------
Justin Perreault