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 |
Convertible Series B Participating preferred stock
|
Â
(1)
|
Â
(2)
|
Common Stock
|
1,825,911
|
$
(3)
|
D
|
Â
|
Convertible Series C Participating preferred stock
|
Â
(4)
|
Â
(5)
|
Common Stock
|
1,576,857
|
$
(6)
|
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) |
The convertible Series B participating preferred stock is convertible in the event of a public stock offering by the issuer, on a 1-to-1.6321 basis and has no expiration date. |
(2) |
The convertible Series B participating preferred stock is convertible in the event of a public stock offering by the issuer, on a 1-to-1.6321 basis and has no expiration date. |
(3) |
The convertible Series B participating preferred stock is convertible in the event of a public stock offering by the issuer, on a 1-to-1.6321 basis and has no expiration date. |
(4) |
The convertible Series C participating preferred stock is convertible in the event of a public stock offering by the issuer, on a 1-to-1.1706 basis and has no expiration date. |
(5) |
The convertible Series C participating preferred stock is convertible in the event of a public stock offering by the issuer, on a 1-to-1.1706 basis and has no expiration date. |
(6) |
The convertible Series C participating preferred stock is convertible in the event of a public stock offering by the issuer, on a 1-to-1.1706 basis and has no expiration date. |