0001104659-16-097142.txt : 20160216 0001104659-16-097142.hdr.sgml : 20160215 20160216121458 ACCESSION NUMBER: 0001104659-16-097142 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20160216 DATE AS OF CHANGE: 20160216 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GLAUKOS Corp CENTRAL INDEX KEY: 0001192448 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-89252 FILM NUMBER: 161425265 BUSINESS ADDRESS: STREET 1: 26051 MERIT CIRCLE STREET 2: SUITE 103 CITY: LAGUNA HILLS STATE: CA ZIP: 92653 BUSINESS PHONE: 949-367-9600 MAIL ADDRESS: STREET 1: 26051 MERIT CIRCLE, SUITE 103 CITY: LAGUNA HILLS STATE: CA ZIP: 92653 FORMER COMPANY: FORMER CONFORMED NAME: GLAUKOS CORP DATE OF NAME CHANGE: 20020925 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Burns Thomas William CENTRAL INDEX KEY: 0001644557 FILING VALUES: FORM TYPE: SC 13G MAIL ADDRESS: STREET 1: C/O GLAUKOS CORPORATION, STREET 2: 26051 MERIT CIRCLE, SUITE 103 CITY: LAGUNA HILLS STATE: CA ZIP: 92653 SC 13G 1 a16-4398_1sc13g.htm SC 13G

 

 

UNITED STATES

 

 

SECURITIES AND EXCHANGE COMMISSION

 

 

Washington, D.C. 20549

 

 

 

 

SCHEDULE 13G

(Amendment No.     )*

 

Under the Securities Exchange Act of 1934

GLAUKOS CORPORATION

(Name of Issuer)

Common Stock

(Title of Class of Securities)

377322102

(CUSIP Number)

December 31, 2015

(Date of Event Which Requires Filing of this Statement)

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

o

Rule 13d-1(b)

o

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 disclosures provided in a prior cover page.

 

The information required on 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).

 


 

CUSIP No. 377322102

SCHEDULE 13G

 

 

 

1

Names of Reporting Persons
Thomas W. Burns

 

 

2

Check the Appropriate Box if a Member of a Group

 

 

(a)

o

 

 

(b)

o

 

 

3

SEC Use Only

 

 

4

Citizenship or Place of Organization
USA

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With

5

Sole Voting Power
2,754,056(1)

 

6

Shared Voting Power
100,000(2)

 

7

Sole Dispositive Power
2,754,056(1)

 

8

Shared Dispositive Power
100,000(2)

 

 

9

Aggregate Amount Beneficially Owned by Each Reporting Person
2,854,056

 

 

10

Check if the Aggregate Amount in Row (9) Excludes Certain Shares  o

 

 

11

Percent of Class Represented by Amount in Row (9)
8.4%(3)

 

 

12

Type of Reporting Person
IN

 

(1)                                 Consists of 1,388 shares and (i) 1,687,310 shares issuable upon the exercise of options that are held directly by Mr. Burns, (ii) 238,107 shares held by the Burns Annuity Trust, of which Mr. Burns is a beneficiary and co-Trustee, (iii) 120,000 shares held by the Burns Charitable Remainder Trust, of which Mr. Burns is a beneficiary and co-Trustee, (iv) 607,251 shares held by the Burns Family Trust of which Mr. Burns is a beneficiary and co-Trustee and (v) 100,000 shares held by the Janet M. Burns Irrevocable Trust, of which Mr. Burns is trustee and Mr. Burns’ spouse is a beneficiary. The number of shares issuable upon the exercise of options includes 62,187 shares subject to options that are currently exercisable but that are not subject to vesting within 60 days of December 31, 2015 and accordingly, if exercised, are subject to a repurchase right until vested.

 

(2)                                 Represents 100,000 shares held by the Thomas W. Burns Irrevocable Trust, of which Mr. Burns is a beneficiary.

 

(3)                                 Based upon 32,181,221 shares of Glaukos Corporation common stock outstanding at December 31, 2015.

2


 

CUSIP No. 377322102

SCHEDULE 13G

 

 

 

Item 1(a)

Name of Issuer:
Glaukos Corporation (“Issuer”)

Item 1(b)

Address of Issuer’s Principal Executive Offices:
26051 Merit Circle, Suite 103, Laguna Hills, California 92653

 

Item 2(a)

Name of Person Filing:
Thomas W. Burns

Item 2(b)

Address of Principal Business Office or, if none, Residence
Same as Item 1(b)

Item 2(c)

Citizenship
See Row 4 of cover page

Item 2(d)

Title of Class of Securities:
Common stock, $0.001 par value per share

Item 2(e)

CUSIP Number:
377322102

 

Item 3.

Statement filed pursuant to Rule 13d-1(b) or 13d-2(b) or (c):

 

Not applicable.

 

3


 

CUSIP No. 377322102

SCHEDULE 13G

 

 

 

Item 4.

Ownership

 

 

(a)

Amount beneficially owned:   

See Row 9 of cover page.

 

(b)

Percent of class.   

See Row 11 of cover page.

 

(c)

Number of shares as to which the person has:

 

 

 

i.

Sole power to vote or to direct the vote:   

See Row 5 of cover page.

 

 

ii.

Shared power to vote or to direct the vote:    

See Row 6 of cover page.

 

 

iii.

Sole power to dispose of or to direct the disposition of:   

See Row 7 of cover page.

 

 

iv.

Shared power to dispose or to direct the disposition of:   

See Row 8 of cover page.

 

Item 5.

Ownership of Five Percent or Less of a Class

 

Not applicable.

 

Item 6.

Ownership of More than Five Percent on Behalf of Another Person

 

Not applicable.

 

Item 7.

Identification and Classification of Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person

 

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.

Certifications

 

Not applicable.

 

4


 

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.

 

Dated:  February 12, 2016

 

 

 

 

Thomas W. Burns

 

 

 

/s/ Thomas W. Burns

 

 

 

5