0001181431-14-039782.txt : 20141229
0001181431-14-039782.hdr.sgml : 20141225
20141229170831
ACCESSION NUMBER: 0001181431-14-039782
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20141223
FILED AS OF DATE: 20141229
DATE AS OF CHANGE: 20141229
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: INTERLEUKIN GENETICS INC
CENTRAL INDEX KEY: 0001037649
STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835]
IRS NUMBER: 943123681
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 135 BEAVER ST
CITY: WATHAM
STATE: MA
ZIP: 02452
BUSINESS PHONE: 1-781-398-0700
MAIL ADDRESS:
STREET 1: 135 BEAVER ST
CITY: WATHAM
STATE: MA
ZIP: 02452
FORMER COMPANY:
FORMER CONFORMED NAME: MEDICAL SCIENCE SYSTEMS INC
DATE OF NAME CHANGE: 19971003
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BASKETT FOREST
CENTRAL INDEX KEY: 0001277631
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32715
FILM NUMBER: 141313413
4
1
rrd420857.xml
X0306
4
2014-12-23
0
0001037649
INTERLEUKIN GENETICS INC
ILIU
0001277631
BASKETT FOREST
1954 GREENSPRING DRIVE
SUITE 600
TIMONIUM
MD
21093
0
0
1
0
Common Stock
2014-12-23
4
P
0
19868965
0.1003
A
35298087
I
See Note 1
Common Stock Warrant (right to buy)
0.1003
2014-12-23
4
P
0
19868965
0
A
2014-12-23
2021-12-23
Common Stock
19868965
19868965
I
See Note 1
The Reporting Person is a Director of NEA 14 GP, LTD, which is the sole general partner of NEA Partners 14, L.P. ("NEA Partners 14"). NEA Partners 14 is the sole general partner of New Enterprise Associates 14, L.P. ("NEA 14"). NEA 14 is the sole member of Growth Equity Opportunities Fund III, LLC ("GEO") , the direct beneficial owner of the Shares. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of the Shares held by GEO, except to the extent of his pecuniary interest therein.
/s/ Sasha Keough, attorney-in-fact
2014-12-29