FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 01/29/2014 |
3. Issuer Name and Ticker or Trading Symbol
Celladon Corp [ CLDN ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 417,259 | I | By entities affiliated with Enterprise Partners(1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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: 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 | (2) | (2) | Common Stock | 926,621(3) | 0.00(2) | I | By entities affiliated with Enterprise Partners(1)(2) |
Junior Convertible Preferred Stock | (4) | (4) | Common Stock | 459,668(3) | 0.00(4) | I | By entities affiliated with Enterprise Partners(4) |
Convertible Promissory Notes | (5) | (5) | Common Stock | $106,478.92 | (5) | I | By entities affiliated with Enterprise Partners(5) |
Series A-1 Preferred Warrants | 10/15/2013 | 10/15/2018 | Series A-1 Preferred Stock | 20,883(3) | 5.61(6) | I | By entities affiliated with Enterprise Partners(7) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. Shares held as follows: 198,405 by Enterprise Partners Liquidating Trust V, L.P.; 210,279 by Enterprise Partners Liquidating Trust VI, L.P.; and 8,575 by Enterprise Partners Management, LLC. |
2. The shares of Series A-1 Preferred Stock have no expiration date and are convertible at any time at the election of the holder. Each share of Series A-1 Preferred Stock will automatically convert on a one-for-one basis into shares of common stock upon the closing of the Issuer's initial public offering. The shares are held as follows: 405,973 by Enterprise Partners Liquidating Trust V, L.P; 510,034 by Enterprise Partners Liquidating Trust VI, L.P.; and 10,614 by Enterprise Partners Management, LLC. |
3. Share numbers assume or give effect to the 1-for-12.49 reverse stock split of the Issuer's Common Stock effected on October 25, 2013, which will be effective for the Preferred Stock upon its conversion to Common Stock immediately prior to the closing of the Issuer's Initial Public Offering |
4. The shares of Junior Preferred Stock have no expiration date and are convertible at any time at the election of the holder. Each share of Junior Preferred Stock will automatically convert on a one-for-one basis into shares of common stock upon the closing of the Issuer's initial public offering. The shares are held as follows: 216,498 by Enterprise Partners Liquidating Trust V, L.P; 233,366 by Enterprise Partners Liquidating Trust VI, L.P.; and 9,804 by Enterprise Partners Management, LLC |
5. Consists of principal that, together with accrued interest, will convert immediately prior to the closing of the Issuer's initial public offering into shares of Common Stock at a conversion price equal to the public offering price of the Common Stock sold in the Issuer's initial public offering as follows: $43,752.19 by Enterprise Partners Liquidating Trust V, L.P; $43,752.19 by Enterprise Partners Liquidating Trust VI, L.P.; and $18,974.54 by Enterprise Partners Management, LLC. |
6. The exercise price has been adjusted to give effect to the 1-for-12.49 reverse stock split of the Issuer's Common Stock effected on October 25, 2013. |
7. Consists of warrants to purchase shares of Series A-1 preferred stock as follows: 8,581 issued to Enterprise Partners Liquidating Trust V, L.P.; 8,581 issued to Enterprise Partners Liquidating Trust VI, L.P.; and 3,721 issued to Enterprise Partners Management, LLC. |
Remarks: |
/s/ Carlton J. Eibl, Managing Director | 01/29/2014 | |
/s/ Carlton J. Eibl, Managing Director of Enterprise Partners Management LLC, as Trustee | 01/29/2014 | |
/s/ Carlton J. Eibl, Managing Director of Enterprise Partners Management LLC, as Trustee | 01/29/2014 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |