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
CALIX, INC [ CALX ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 07/19/2011 | ||||||||||||||||||||||||||
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 | 07/19/2011 | A | 2,833(1) | A | $0 | 7,366(2) | D | |||
Common Stock | 10/25/2010 | J(3) | 62,524 | D | $0 | 0 | I | See Note(4) | ||
Common Stock | 10/25/2010 | J(3) | 2,880,916 | D | $0 | 0 | I | See Note(5) |
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 Option (right to buy) | $21.67 | 07/19/2011 | A | 6,250 | (6) | 07/19/2021 | Common Stock | 6,250 | $0 | 6,250 | D |
Explanation of Responses: |
1. Restricted Stock Units ("RSUs"). The Reporting Person is entitled to receive one (1) share of Common Stock for each one (1) RSU upon vesting. 100% of the RSUs will vest on the one (1) year anniversary following July 19, 2011. |
2. Includes 5,855 RSUs. |
3. Effective as of October 25, 2010, the Reporting Person separated from Foundation Capital and as of that date no longer had or shared any voting or dispositive authority over the shares of Common Stock held by Foundation Capital V Principals Fund, LLC and Foundation Capital V, L.P. Therefore, effective as of October 25, 2010, the Reporting Person ceased to have beneficial ownership of such shares. |
4. Shares are held by Foundation Capital V Principals Fund, LLC. Prior to October 25, 2010, the Reporting Person was a managing member of Foundation Capital Management Co. V, LLC, which is the sole general partner of Foundation Capital V Principals Fund, LLC. |
5. Shares are held by Foundation Capital V, L.P. Prior to October 25, 2010, the Reporting Person was a managing member of Foundation Capital Management Co. V, LLC, which is the sole general partner of Foundation Capital V, L.P. |
6. 1/12th of the shares subject to the option will vest and become exercisable in twelve (12) successive and equal monthly installments after July 19, 2011 ("the Vesting Commencement Date"), such that 100% for the shares subject to the option will be fully vested and exercisable on the first anniversary of the Vesting Commencement Date. |
/s/ Michael Ashby as Attorney-in-Fact for Adam Grosser | 07/21/2011 | |
** 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). | ||
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. |