0001193125-15-041493.txt : 20150210 0001193125-15-041493.hdr.sgml : 20150210 20150210154633 ACCESSION NUMBER: 0001193125-15-041493 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 2 FILED AS OF DATE: 20150210 DATE AS OF CHANGE: 20150210 GROUP MEMBERS: ASCENSION HEALTH VENTURES II LLC SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OCULAR THERAPEUTIX, INC CENTRAL INDEX KEY: 0001393434 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-88264 FILM NUMBER: 15593658 BUSINESS ADDRESS: STREET 1: 36 CROSBY DRIVE STREET 2: SUITE 101 CITY: BEDFORD STATE: MA ZIP: 01730 BUSINESS PHONE: 781-895-3235 MAIL ADDRESS: STREET 1: 36 CROSBY DRIVE STREET 2: SUITE 101 CITY: BEDFORD STATE: MA ZIP: 01730 FORMER COMPANY: FORMER CONFORMED NAME: I-THERAPEUTIX INC DATE OF NAME CHANGE: 20070315 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: CHV II, L.P. CENTRAL INDEX KEY: 0001615761 IRS NUMBER: 260534243 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: ASCENSION VENTURES STREET 2: 101 SOUTH HANLEY ROAD, SUITE 200 CITY: CLAYTON STATE: MS ZIP: 63105 BUSINESS PHONE: 314-733-8116 MAIL ADDRESS: STREET 1: ASCENSION VENTURES STREET 2: 101 SOUTH HANLEY ROAD, SUITE 200 CITY: CLAYTON STATE: MS ZIP: 63105 SC 13G 1 d867574dsc13g.htm SC 13G SC 13G

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

SCHEDULE 13G

Under the Securities Exchange Act of 1934

(Amendment No.     )*

 

 

OCULAR THERAPEUTIX

(Name of Issuer)

COMMON

(Title of Class of Securities)

675767A100

(CUSIP Number)

DECEMBER 31, 2014

(Date of Event Which Requires Filing of this Statement)

 

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

¨ Rule 13d-1(b)

¨ Rule 13d-1(c)

x Rule 13d-1(d)

 

* The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 

 

 

13G

 

CUSIP No. 675767A100   Page 2 of 6 Pages

 

  1.   

Names of reporting persons

I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)

 

CHV II, L.P. 26-0534243

  2.  

Check the appropriate box if a member of a group

(a)  ¨        (b)  ¨

 

  3.  

SEC use only

 

  4.  

Citizenship or place of organization

 

    Delaware

Number of

shares

beneficially

owned by

each

reporting

person

with

    5.    

Sole voting power

 

    2,100,138

   6.   

Shared voting power

 

   7.   

Sole dispositive power

 

    2,100,138

   8.   

Shared dispositive power

 

  9.  

Aggregate amount beneficially owned by each reporting person

 

    2,100,138

10.  

Check box if the aggregate amount in Row (9) excludes certain shares    ¨

 

11.  

Percent of class represented by amount in Row 9

 

    9.849%

12.  

Type of reporting person

 

    PN

 

13G

 

CUSIP No. 675767A100   Page 3 of 6 Pages

 

  1.   

Names of reporting persons

I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)

 

ASCENSION HEALTH VENTURES II, LLC 26-0624407

(dba Ascension Ventures, LLC)

  2.  

Check the appropriate box if a member of a group

(a)  ¨        (b)  ¨

 

  3.  

SEC use only

 

  4.  

Citizenship or place of organization

 

    Missouri

Number of

shares

beneficially

owned by

each

reporting

person

with

    5.    

Sole voting power

 

    2,100,138

   6.   

Shared voting power

 

   7.   

Sole dispositive power

 

    2,100,138

   8.   

Shared dispositive power

 

  9.  

Aggregate amount beneficially owned by each reporting person

 

    2,100,138

10.  

Check box if the aggregate amount in Row (9) excludes certain shares    ¨

 

11.  

Percent of class represented by amount in Row 9

 

    9.849%

12.  

Type of reporting person

 

    OO

 

13G

 

CUSIP No. 675767A100    Page 4 of 6 Pages

 

Item 1(a). Name of Issuer:

Ocular Therapeutix, Inc.

 

Item 1(b). Address of Issuer’s Principal Executive Offices:

Ocular Therapeutix, Inc., 36 Crosby Drive, Suite 101 Bedford, Massachusetts 01730

 

Item 2(a). Name of Person Filing:

This statement is being filed by the following persons with respect to certain shares of Common Stock of the Issuer:

Ascension Health Ventures II, LLC (dba Ascension Ventures, LLC), General Partner of CHV II, LP

CHV II, LP

 

Item 2(b). Address of Principal Business Office or, if None, Residence:

101 South Hanley Road, Suite 200, Clayton, MO 63105

 

Item 2(c). Citizenship:

Ascension Ventures II, LLC – Missouri

CHV II, LP - Delaware

 

Item 2(d). Title of Class of Securities:

Common Stock

 

Item 2(e). CUSIP Number:

675767A100

Item 3. If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:

 

(a)    ¨    Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o).
(b)    ¨    Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c).
(c)    ¨    Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c).
(d)    ¨    Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8).
(e)    x    An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E);
(f)    ¨    An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F);
(g)    ¨    A parent holding company or control person in accordance with §240.13d-1(b)(1)(ii)(G);
(h)    ¨    A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);
(i)    ¨    A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3);
(j)    ¨    Group, in accordance with §240.13d-1(b)(1)(ii)(J).

13G

 

CUSIP No. 675767A100    Page 5 of 6 Pages

 

Item 4. Ownership.

Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.

 

  (a) Amount beneficially owned: 2,100,138(1)

 

  (b) Percent of class: 9.849%

The foregoing percentage is calculated based on the 21,322,433 shares of Common Stock of Ocular Therapeutix, Inc. outstanding as of September 30, 2014 as reported in the issuer’s Quarterly Report on Form 10-Q filed with the SEC on November 12, 2014.

 

  (c) Number of shares as to which such person has:

 

  (i) Sole power to vote or to direct the vote: 2,100,138

 

  (ii) Shared power to vote or to direct the vote: 0

 

  (iii) Sole power to dispose or to direct the disposition of: 2,100,138

 

  (iv) Shared power to dispose or to direct the disposition of: 0

 

Item 5. Ownership of Five Percent or Less of a Class.

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than 5 percent of the class of securities, check the following ¨.

 

Item 6. Ownership of More than Five Percent on Behalf of Another Person.

Not Applicable

 

Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company.

Not Applicable

 

Item 8. Identification and Classification of Members of the Group.

Not Applicable

 

Item 9. Notice of Dissolution of Group.

Not Applicable

 

Item 10. Certification.

Not Applicable

13G

 

CUSIP No. 675767A100 Page 6 of 6 Pages

 

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Date: February 10, 2015

 

/s/ LOGO
Matthew I. Hermann, Senior Managing Director
Ascension Ventures II, LLC, General Partner of CHV II, L.P.
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