SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
DRAPER FISHER JURVETSON FUND V LP

(Last) (First) (Middle)
2882 SAND HILL ROAD, SUITE 150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
EPOCRATES INC [ EPOC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% Owner
3. Date of Earliest Transaction (Month/Day/Year)
02/07/2011
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/07/2011 C 836,107 A $0 836,107 I See Footnote(1)
Common Stock 02/07/2011 C 533,091 A $0 1,369,198 I See Footnote(1)
Common Stock 02/07/2011 C 449,819 A $0 1,819,017 I See Footnote(1)
Common Stock 02/07/2011 C 67,792 A $0 67,792 I See Footnote(2)
Common Stock 02/07/2011 C 43,223 A $0 111,015 I See Footnote(2)
Common Stock 02/07/2011 C 36,471 A $0 147,486 I See Footnote(2)
Common Stock 150,655 I See Footnote(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Convertible Preferred Stock $0 02/07/2011 C 1,063,750 (4) (4) Common Stock 836,107 $0 0 I See Footnote(1)
Series A Convertible Preferred Stock $0 02/07/2011 C 86,250 (4) (4) Common Stock 67,792 $0 0 I See Footnote(2)
Series B Convertible Preferred Stock $0 02/07/2011 C 587,018 (5) (5) Common Stock 533,091 $0 0 I See Footnote(1)
Series B Convertible Preferred Stock $0 02/07/2011 C 47,596 (5) (5) Common Stock 43,223 $0 0 I See Footnote(2)
Series C Convertible Preferred Stock $0 02/07/2011 C 572,289 (4) (4) Common Stock 449,819 $0 0 I See Footnote(1)
Series C Convertible Preferred Stock $0 02/07/2011 C 46,402 (4) (4) Common Stock 36,471 $0 0 I See Footnote(2)
1. Name and Address of Reporting Person*
DRAPER FISHER JURVETSON FUND V LP

(Last) (First) (Middle)
2882 SAND HILL ROAD, SUITE 150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% Owner
1. Name and Address of Reporting Person*
Draper Fisher Jurvetson Partners V, LLC

(Last) (First) (Middle)
2882 SAND HILL ROAD, SUITE 150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% Owner
1. Name and Address of Reporting Person*
Draper Fisher Jurvetson Management Co V, LLC

(Last) (First) (Middle)
2882 SAND HILL ROAD, SUITE 150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% Owner
1. Name and Address of Reporting Person*
DRAPER TIMOTHY C

(Last) (First) (Middle)
2882 SAND HILL ROAD, SUITE 150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% Owner
1. Name and Address of Reporting Person*
Fisher John H N

(Last) (First) (Middle)
2882 SAND HILL ROAD, SUITE 150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% Owner
1. Name and Address of Reporting Person*
Jurvetson Stephen T

(Last) (First) (Middle)
2882 SAND HILL ROAD, SUITE 150

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% Owner
Explanation of Responses:
1. The shares are owned by Draper Fisher Jurvetson Fund V, L.P. ("DFJ Fund V"). Draper Fisher Jurvetson Management Co. V, LLC is the general partner of DFJ Fund V and thereby has sole voting and investment control over the shares owned by DFJ Fund V. Timothy C. Draper, John H.N. Fisher and Stephen T. Jurvetson are the managing directors of Draper Fisher Jurvetson Management Co. V, LLC. They share voting and investment control over the shares owned DFJ Fund V. The managing directors disclaim beneficial ownership of the shares owned by DFJ Fund V except to the extent of their respective pecuniary interest therein. The general partner of DFJ Fund V disclaims beneficial ownership of the shares owned by DFJ Fund V except to the extent of its pecuniary interest therein.
2. The shares are owned by Draper Fisher Jurvetson Partners V, LLC ("DFJ Partners V"). Timothy C. Draper, John H.N. Fisher and Stephen T. Jurvetson are the managing members of DFJ Partners V. They share voting and investment control over the shares owned by DFJ Partners V. The managing members disclaim beneficial ownership of the shares owned by the DFJ Partners V except to the extent of their respective pecuniary interest therein.
3. The shares are held indirectly by Mr. Draper through the Timothy C. Draper 2010 Annuity Trust.
4. Each of the shares of the Issuer's Series A Convertible Preferred Stock and Series C Convertible Preferred Stock automatically converted into 0.786 shares of the Issuer's Common Stock immediately prior to the closing of the Issuer's initial public offering and have no expiration date.
5. Each of the shares of the Issuer's Series B Convertible Preferred Stock automatically converted into 0.90813437 shares of the Issuer's Common Stock immediately prior to the closing of the Issuer's initial public offering and has no expiration date.
Draper Fisher Jurvetson Fund V, L.P., By: Draper Fisher Jurvetson Management Co. V, L.L.C., Its: General Partner, By: /s/ John Fisher, Managing Member 02/07/2011
Draper Fisher Jurvetson Management Co. V, L.L.C., By: /s/ John Fisher, Managing Member 02/07/2011
Draper Fisher Jurvetson Partners V, LLC, By: /s/ John Fisher, Managing Member 02/07/2011
/s/ Timothy C. Draper 02/07/2011
/s/ John H.N. Fisher 02/07/2011
/s/ Stephen T. Jurvetson 02/07/2011
** 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 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).
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