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 Convertible Preferred Stock
(1)
|
Â
(1)
|
Â
(1)
|
Common Stock
|
2,281,296
|
$
(1)
|
I
|
Directly owned by Evergreen IV, L.P. See Explanation of Reponses
(2)
(3)
|
Series B Convertible Preferred Stock
(1)
|
Â
(1)
|
Â
(1)
|
Common Stock
|
1,256,282
|
$
(1)
|
I
|
Directly owned by Evergreen IV, L.P. See Explanation of Reponses
(2)
(3)
|
Series C Convertible Preferred Stock
(1)
|
Â
(1)
|
Â
(1)
|
Common Stock
|
575,020
|
$
(1)
|
I
|
Directly owned by Evergreen IV, L.P. See Explanation of Reponses
(2)
(3)
|
Series D Convertible Preferred Stock
(1)
|
Â
(1)
|
Â
(1)
|
Common Stock
|
278,681
|
$
(1)
|
I
|
Directly owned by Evergreen IV, L.P. See Explanation of Reponses
(2)
(3)
|
* |
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) |
Represents shares directly held by Evergreen IV, L.P. Each share of preferred stock of the Issuer is (i) convertible at any time into shares of the Issuer's common stock on a one-for-one basis, and have no expiration date, and (ii) will automatically convert into shares of the Issuer's common stock immediately prior to the closing of the Issuer's initial public offering. |
(2) |
The Reporting Person is one of the seven individual members of the investment committee of Evergreen IV, L.P. |
(3) |
The Reporting Person disclaims beneficial ownership of the securities, except to the extent of such Reporting Person's pecuniary interest therein, if any. |