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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
NETLOGIC MICROSYSTEMS INC [ NETL ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 07/14/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | 01/26/2004 | M | 5,000 | A | $2 | 55,000 | D | |||
Common Stock | 02/13/2004 | M | 2,500 | A | $2 | 57,500 | D | |||
Common Stock | 07/06/2004 | M | 5,000 | A | $2 | 62,500 | D | |||
Common Stock | 07/14/2004 | C | 28,846 | A | $0 | 91,346(1) | D | |||
Common Stock | 07/06/2004 | X | 2,500 | A | $2 | 2,500 | I | see footnote(2) | ||
Common Stock | 07/14/2004 | C | 123,077 | A | $0 | 125,577(1) | I | see footnote(2) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 | ||||||||
Stock Options (right to buy | $2 | 01/20/2004 | A | 2,500 | (3) | 01/19/2014 | Common Stock | 2,500 | $0 | 2,500 | D | ||||
Stock Options (right to buy) | $2 | 01/26/2004 | M | 2,500 | (4) | 03/04/2013 | Common Stock | 2,500 | $0 | 0 | D | ||||
Stock Options (right to buy) | $2 | 01/26/2004 | M | 2,500 | (4) | 03/04/2013 | Common Stock | 2,500 | $0 | 0 | D | ||||
Stock Options (right to buy) | $2 | 02/13/2004 | M | 2,500 | (4) | 01/19/2014 | Common Stock | 2,500 | $0 | 0 | D | ||||
Warrant to Purchase Common Stock | $2 | 03/18/2004 | A | 5,000 | (4) | 07/14/2004 | Common Stock | 5,000 | $0 | 5,000 | D | ||||
Warrant to Purchase Common Stock | $2 | 03/18/2004 | P | 2,500 | (4) | 07/14/2004 | Common Stock | 2,500 | $0 | 2,500 | I | see footnote(2) | |||
Warrant to Purchase Common Stock | $2 | 07/06/2004 | M | 5,000 | (4) | 07/14/2004 | Common Stock | 10,000 | $0 | 0 | D | ||||
Warrant to Purchase Common Stock | $2 | 07/06/2004 | X | 2,500 | (4) | 07/14/2004 | Common Stock | 10,000 | $0 | 0 | I | see footnote(2) | |||
Series B Preferred Stock | $0(5) | 07/14/2004 | C | 100,000 | (6) | 07/14/2004(7) | Common Stock | 25,000 | $0 | 0 | D | ||||
Series C Preferred Stock | $0(5) | 07/14/2004 | C | 400,000 | (6) | 07/14/2004(7) | Common Stock | 100,000 | $0 | 0 | I | see footnote(2) | |||
Series D Preferred Stock | $0(5) | 07/14/2004 | C | 15,385 | (6) | 07/14/2004(7) | Common Stock | 3,846 | $0 | 0 | D | ||||
Series D Preferred Stock | $0(5) | 07/14/2004 | C | 92,308 | (6) | 07/14/2004(7) | Common Stock | 23,077 | $0 | 0 | I | see footnote(2) |
Explanation of Responses: |
1. These shares of common stock were acquired upon the automatic conversion of all shares of each series of preferred stock of the issuer immediately prior to the closing of the issuer's initial public offering. |
2. These shares are held by Huntington Technology Fund, LP. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. The inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 of the Securities Exchange Act of 1934 or for any other purpose. |
3. This option was fully vested upon grant. |
4. These securities were immediately exercisable. |
5. These shares of preferred stock were convertible into shares of common stock of the issuer at a ratio of one share of common stock for every four shares of preferred stock. |
6. These shares of preferred stock were immediately convertible. |
7. These shares of preferred stock automatically converted into shares of common stock immediately prior to the closing of the issuer's initial public offering. |
/S/ Douglas Wright Broyles | 07/16/2004 | |
** 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). | ||
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. |