SEC Form 3
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*
George Jean

(Last) (First) (Middle)
BAY COLONY CORPORATE CENTER
1000 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/18/2011
3. Issuer Name and Ticker or Trading Symbol
Zeltiq Aesthetics Inc [ ZLTQ ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
5. 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 Beneficially Owned
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 7,901,221 I See Footnote(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
1. Name and Address of Reporting Person*
George Jean

(Last) (First) (Middle)
BAY COLONY CORPORATE CENTER
1000 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
ADVANCED TECHNOLOGY VENTURES VII LP

(Last) (First) (Middle)
BAY COLONY CORPORATE CENTER
1000 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Advanced Technology Ventures VII(B), L.P.

(Last) (First) (Middle)
BAY COLONY CORPORATE CENTER
1000 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Advanced Technology Ventures VII(C), L.P.

(Last) (First) (Middle)
BAY COLONY CORPORATE CENTER
1000 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
ATV Entrepreneurs VII, L.P.

(Last) (First) (Middle)
BAY COLONY CORPORATE CENTER
1000 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
ATV Associates VII, L.L.C.

(Last) (First) (Middle)
BAY COLONY CORPORATE CENTER
1000 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Includes 7,416,358 shares held by Advanced Technology Ventures VII, L.P. ("Ventures"), 297,614 shares held by Advanced Technology Ventures VII (B), L.P. ("Ventures B"), 143,051 shares held by Advanced Technology Ventures VII (C), L.P. ("Ventures C") and 44,198 shares held by ATV Entrepreneurs VII, L.P. ("Entrepreneurs", and collectively with Ventures, Ventures B and Ventures C, the "ATV Funds"). The shares directly held by the ATV Funds are indirectly held by ATV Associates VII, L.L.C. ("ATV Associates") as general partner, and each of five individual managing directors of ATV Associates. The individual managing directors of ATV Associates share voting and dispositive power over the shares directly held by the ATV Funds. ATV Associates and each of the other reporting persons disclaims beneficial ownership of the securities except to the extent of their respective pecuniary interest therein.
Remarks:
Exhibit List: Exhibit 99.1 - Signatures of Joint Filers
See Signatures on Exhibit 10/18/2011
** 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 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.