0001104659-15-048877.txt : 20150630
0001104659-15-048877.hdr.sgml : 20150630
20150630161904
ACCESSION NUMBER: 0001104659-15-048877
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150626
FILED AS OF DATE: 20150630
DATE AS OF CHANGE: 20150630
ISSUER:
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
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FHM V, LP
CENTRAL INDEX KEY: 0001346948
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37463
FILM NUMBER: 15961630
BUSINESS ADDRESS:
STREET 1: 601 UNION STREET, SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
BUSINESS PHONE: (206) 621-7200
MAIL ADDRESS:
STREET 1: 601 UNION STREET, SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Topper James N
CENTRAL INDEX KEY: 0001341382
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37463
FILM NUMBER: 15961631
MAIL ADDRESS:
STREET 1: 550 HAMILTON AVENUE, SUITE 100
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Heron Patrick J
CENTRAL INDEX KEY: 0001365617
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37463
FILM NUMBER: 15961632
MAIL ADDRESS:
STREET 1: 550 HAMILTON AVE., SUITE 100
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Naini Nader J
CENTRAL INDEX KEY: 0001344203
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37463
FILM NUMBER: 15961633
MAIL ADDRESS:
STREET 1: 601 UNION STREET, SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FRAZIER ALAN D
CENTRAL INDEX KEY: 0001018534
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37463
FILM NUMBER: 15961634
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FHM V, LLC
CENTRAL INDEX KEY: 0001346944
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37463
FILM NUMBER: 15961636
BUSINESS ADDRESS:
STREET 1: 601 UNION STREET, SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
BUSINESS PHONE: (206) 621-7200
MAIL ADDRESS:
STREET 1: 601 UNION STREET, SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Frazier Healthcare V, LP
CENTRAL INDEX KEY: 0001341169
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37463
FILM NUMBER: 15961637
BUSINESS ADDRESS:
STREET 1: 601 UNION STREET, SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
BUSINESS PHONE: (206) 621-7200
MAIL ADDRESS:
STREET 1: 601 UNION STREET, SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Every Nathan R
CENTRAL INDEX KEY: 0001531105
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37463
FILM NUMBER: 15961635
MAIL ADDRESS:
STREET 1: FRAZIER HEALTHCARE VENTURES
STREET 2: 601 UNION TWO UNION SQUARE SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
4
1
a4.xml
4
X0306
4
2015-06-26
0
0001192448
GLAUKOS Corp
GKOS
0001341169
Frazier Healthcare V, LP
601 UNION STREET
SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001346944
FHM V, LLC
601 UNION STREET
SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001531105
Every Nathan R
601 UNION STREET
SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001018534
FRAZIER ALAN D
601 UNION STREET
SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001344203
Naini Nader J
601 UNION STREET
SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001365617
Heron Patrick J
601 UNION STREET
SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001341382
Topper James N
601 UNION STREET
SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001346948
FHM V, LP
601 UNION STREET
SUITE 3200
SEATTLE
WA
98101
0
0
1
0
Series D Convertible Preferred Stock
2015-06-26
4
X
0
24705
7.65
A
Common Stock
24705
674510
D
Series D Convertible Preferred Stock Warrant (right to buy)
7.65
2015-06-26
4
X
0
24705
0
D
2010-09-15
2017-09-15
Common Stock
24705
0
D
The shares of Series D Convertible Preferred Stock, will automatically convert into shares of common stock on a 1:1 basis immediately prior to the consummation of Issuer's initial public offering ("IPO") and have no expiration date.
This report is filed jointly by Frazier Healthcare V, L.P., a Delaware limited partnership ("FH-V''), FHM V, L.P., a Delaware limited partnership ("FHM V L.P.''), FHM V LLC a Delaware limited liability company ("FHM V LLC''), Nathan Every, Alan Frazier, Nader Naini, Patrick Heron and James Topper. Shares and warrants are held directly by FH-V. FHM V, L.P. serves as the sole general partner of FH-V and owns no shares directly. FHM V LLC serves as the sole general partner of FHM V, L.P. and owns no shares directly. Nathan Every, Alan Frazier, Nader Naini, Patrick Heron and James Topper are members of FHM V, LLC and share voting and dispositive power over the shares held by FH-V; however, they disclaim beneficial ownership of the shares held by FH-V except to the extent of their pecuniary interests therein.
If not exercised prior to the IPO, the warrants would have automatically net exercised immediately prior to the IPO at the IPO price per share.
Frazier Healthcare V, L.P., By: FHM V, L.P., its general partner, By FHM V, LLC, its general partner, By: /s/ Steve Bailey, Chief Financial Officer
2015-06-29
FHM V, L.P., By FHM V, LLC, its general partner, By: /s/ Steve Bailey, Chief Financial Officer
2015-06-29
FHM V, LLC, By: /s/ Steve Bailey, Chief Financial Officer
2015-06-29
/s/ Nathan Every
2015-06-29
/s/ Alan Frazier
2015-06-29
/s/ Nader Naini
2015-06-29
/s/ Patrick Heron
2015-06-29
/s/ James Topper
2015-06-29