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 Preferred Stock
|
(3)
|
(4)
|
Common Stock
|
4,040,404
(1)
(5)
|
$
0
|
D
(2)
|
|
Series B Preferred Stock
|
(3)
|
(4)
|
Common Stock
|
1,080,146
(1)
(6)
|
$
0
|
D
(2)
|
|
Series D Preferred Stock
|
(3)
|
(4)
|
Common Stock
|
169,892
(1)
(7)
|
$
0
|
D
(2)
|
|
Warrant to Purchase Series D Preferred Stock
(8)
|
(9)
|
05/25/2013 |
Series D Preferred Stock
(8)
|
30,816
(1)
|
$
5.96
(1)
|
D
(2)
|
|
* |
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) |
Reflects a 2-for-3 reverse stock split of the Issuer's outstanding securities effected immediately prior to the effectiveness of the Issuer's S-1 Registration Statement (Commission File No. 333-164044). |
(2) |
Held by Maxygen, Inc. ("Maxygen"). James R. Sulat, a member of the Issuer's board of directors, is the Chief Executive Officer, Chief Financial Officer and a member of the board of directors of Maxygen, and, as such, may be deemed to be the beneficial owner of the securities held by Maxygen. Mr. Sulat disclaims beneficial ownership of all securities held by Maxygen, except to the extent of his pecuniary interest therein. |
(3) |
The shares are immediately convertible. |
(4) |
The shares do not have an expiration date. |
(5) |
Represents the total shares of Common Stock that are issuable upon conversion of the Series A Preferred Stock, each share of which will convert on a 1.010101-for-1 basis into Common Stock upon the closing of the Issuer's initial public offering. |
(6) |
Each share of Series B Preferred Stock will automatically convert on a 1-for-1 basis into Common Stock upon the closing of the Issuer's initial public offering. |
(7) |
Each share of Series D Preferred Stock will automatically convert on a 1-for-1 basis into Common Stock upon the closing of the Issuer's initial public offering. |
(8) |
Upon completion of the Issuer's initial public offering, this warrant to purchase shares of Series D Preferred Stock will automatically convert into a warrant to purchase an equal number of shares of the Issuer's Common Stock. |
(9) |
This warrant is immediately exercisable. |