0001209191-15-041354.txt : 20150511 0001209191-15-041354.hdr.sgml : 20150511 20150511211238 ACCESSION NUMBER: 0001209191-15-041354 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150506 FILED AS OF DATE: 20150511 DATE AS OF CHANGE: 20150511 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MERRILL CORP /NEW/ - FA CENTRAL INDEX KEY: 0001047469 IRS NUMBER: 000000000 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE MERRILL CIRCLE STREET 2: ENERGY PARK CITY: ST PAUL STATE: MN ZIP: 55108 BUSINESS PHONE: 800-688-1933 MAIL ADDRESS: STREET 1: ONE MERRILL CIRCLE STREET 2: ENERGY PARK CITY: ST PAUL STATE: MN ZIP: 55108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KANEKO YASUNORI CENTRAL INDEX KEY: 0001277503 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 333-52177 FILM NUMBER: 15852575 MAIL ADDRESS: STREET 1: 509 ROEHAMPTON CITY: HILLS BOROUGH STATE: CA ZIP: 94010 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Skyline Venture Management V, LLC CENTRAL INDEX KEY: 0001434887 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 333-52177 FILM NUMBER: 15852576 BUSINESS ADDRESS: STREET 1: 525 UNIVERSITY AVENUE CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: 650-475-0144 MAIL ADDRESS: STREET 1: 525 UNIVERSITY AVENUE CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Skyline Venture Partners V LP CENTRAL INDEX KEY: 0001419187 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 333-52177 FILM NUMBER: 15852577 BUSINESS ADDRESS: STREET 1: 525 University Avenue STREET 2: Suite 520 CITY: Palo Alto STATE: CA ZIP: 94301 MAIL ADDRESS: STREET 1: 525 University Avenue STREET 2: Suite 520 CITY: Palo Alto STATE: CA ZIP: 94301 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2015-05-06 0 0001047469 MERRILL CORP /NEW/ - FA COLL 0001419187 Skyline Venture Partners V LP 525 UNIVERSITY AVENUE, SUITE 610 PALO ALTO CA 94301 0 0 1 0 0001434887 Skyline Venture Management V, LLC 525 UNIVERSITY AVENUE, SUITE 610 PALO ALTO CA 94301 0 0 1 0 0001277503 KANEKO YASUNORI 525 UNIVERSITY AVENUE, SUITE 610 PALO ALTO CA 94301 0 0 1 0 Series B Convertible Preferred Stock Common Stock 1552795 I see footnote Series C Convertible Preferred Stock Common Stock 382323 I see footnote Series D Convertible Preferred Stock Common Stock 852423 I see footnote All series of Convertible Preferred Stock will automatically convert into Collegium Pharmaceutical, Inc. common stock on a 1-for-6.9 basis immediately prior to the closing of the initial public offering and have no expiration date. The shares are held by Skyline Venture Partners V, L.P. The general partner of Skyline Venture Partners V, L.P. is Skyline Venture Management V, LLC. John G. Freund and Yasunori Kaneko are managers of Skyline Venture Management V, LLC. These individuals share voting and investment power over the shares held by Skyline Venture Management, LLC and disclaim beneficial ownership of all the shares held by Skyline Venture Partners V, L.P. except to the extent of their proportionate pecuniary interest therein. Dr. Freund is a director of the Issuer and, accordingly, files separate Section 16 reports. /s/ Kerensa Kenny, Attorney-in-Fact 2015-05-11