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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 | ||||||||
Series A Convertible Preferred Stock | (1) | 08/07/2013 | C | 7,212 | (1) | (1) | Common Stock | 7,212 | $ 0 | 0 | I | By Thomas Weisel Venture Partners Employee Fund, L.P. (2) | |||
Series A Convertible Preferred Stock | (1) | 08/07/2013 | C | 858,172 | (1) | (1) | Common Stock | 858,172 | $ 0 | 0 | I | By Thomas Weisel Venture Partners, L.P. (3) | |||
Series B Convertible Preferred Stock | (1) | 08/07/2013 | C | 9,838 | (1) | (1) | Common Stock | 9,838 | $ 0 | 0 | I | By Thomas Weisel Venture Partners Employee Fund, L.P. (2) | |||
Series B Convertible Preferred Stock | (1) | 08/07/2013 | C | 1,172,865 | (1) | (1) | Common Stock | 1,172,865 | $ 0 | 0 | I | By Thomas Weisel Venture Partners, L.P. (3) | |||
Series C Convertible Preferred Stock | (1) | 08/07/2013 | C | 2,959 | (1) | (1) | Common Stock | 2,959 | $ 0 | 0 | I | By Thomas Weisel Venture Partners Employee Fund, L.P. (2) | |||
Series C Convertible Preferred Stock | (1) | 08/07/2013 | C | 366,996 | (1) | (1) | Common Stock | 366,996 | $ 0 | 0 | I | By Thomas Weisel Venture Partners, L.P. (3) | |||
Series D Convertible Preferred Stock | (1) | 08/07/2013 | C | 2,450 | (1) | (1) | Common Stock | 2,450 | $ 0 | 0 | I | By Thomas Weisel Venture Partners Employee Fund, L.P. (2) | |||
Series D Convertible Preferred Stock | (1) | 08/07/2013 | C | 303,921 | (1) | (1) | Common Stock | 303,921 | $ 0 | 0 | I | By Thomas Weisel Venture Partners, L.P. (3) | |||
Series E Convertible Preferred Stock | (1) | 08/07/2013 | C | 702 | (1) | (1) | Common Stock | 702 | $ 0 | 0 | I | By Thomas Weisel Venture Partners Employee Fund, L.P. (2) | |||
Series E Convertible Preferred Stock | (1) | 08/07/2013 | C | 87,109 | (1) | (1) | Common Stock | 87,109 | $ 0 | 0 | I | By Thomas Weisel Venture Partners, L.P. (3) | |||
Series G Convertible Preferred Stock | (1) | 08/07/2013 | C | 870 | (1) | (1) | Common Stock | 870 | $ 0 | 0 | I | By Thomas Weisel Venture Partners Employee Fund, L.P. (2) | |||
Series G Convertible Preferred Stock | (1) | 08/07/2013 | C | 107,136 | (1) | (1) | Common Stock | 107,136 | $ 0 | 0 | I | By Thomas Weisel Venture Partners, L.P. (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Born Robert C/O CONTROL4 CORPORATION 11734 S. ELECTION ROAD SALT LAKE CITY, UT 84020 |
X | X |
/s/ Robert Born | 08/07/2013 | |
**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) | Each share of Issuer's Preferred Stock automatically converts into Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering and has no expiration date. |
(2) | These shares are owned directly by Thomas Weisel Venture Partners Employee Fund, L.P. ("TWVP Employee Fund"), whose sole general partner is Thomas Weisel Capital Management LLC. Robert Born is a fund manager for TWVP Employee Fund. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose. Robert Born is a director of Issuer. |
(3) | These shares are owned directly by Thomas Weisel Venture Partners, L.P. ("TWVP "), whose sole general partner is Thomas Weisel Venture Partners LLC. Robert Born is a fund manager for TWVP. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose. Robert Born is a director of Issuer. |