0001209191-16-139234.txt : 20160830 0001209191-16-139234.hdr.sgml : 20160830 20160830215157 ACCESSION NUMBER: 0001209191-16-139234 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160726 FILED AS OF DATE: 20160830 DATE AS OF CHANGE: 20160830 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IMPINJ INC CENTRAL INDEX KEY: 0001114995 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRONIC COMPONENTS, NEC [3679] IRS NUMBER: 912041398 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 FAIRVIEW AVENUE NORTH STREET 2: SUITE 1200 CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 206-517-5300 MAIL ADDRESS: STREET 1: 400 FAIRVIEW AVENUE NORTH STREET 2: SUITE 1200 CITY: SEATTLE STATE: WA ZIP: 98109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BYBEE CLINTON CENTRAL INDEX KEY: 0001219043 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37824 FILM NUMBER: 161861815 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD STREET 2: SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2016-07-26 2016-07-26 0 0001114995 IMPINJ INC PI 0001219043 BYBEE CLINTON 8755 WEST HIGGINS ROAD SUITE 1025 CHICAGO IL 60631 1 0 1 0 Common Stock 2016-07-26 2016-07-26 4 C 0 820935 0.00 A 820935 I See footnotes Common Stock 2016-07-26 2016-07-26 4 C 0 527088 0.00 A 1348023 I See footnotes Common Stock 2016-07-26 2016-07-26 4 X 0 40025 7.46 A 1388048 I See footnotes Common Stock 2016-07-26 2016-07-26 4 F 0 21313 14.00 D 1366735 I See footnotes Series 1 Preferred Stock 2016-07-26 2016-07-26 4 C 0 820935 0.00 D Common Stock 820935 0 I N/A Series 2 Preferred Stock 2016-07-26 2016-07-26 4 C 0 421683 0.00 D Common Stock 421683 0 I N/A Series 2 Preferred Warrant (Right to Buy) 9.32 2016-07-26 2016-07-26 4 X 0 32022 0.00 D 2017-06-30 Common Stock 32022 0 I N/A Each share of Series 1 Preferred Stock automatically converted into one share of Common Stock immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. 815,666 of these shares are held of record by ARCH Venture Fund V, L.P.; and 5,269 of these shares are held of record by ARCH V Entrepreneurs Fund, L.P. ARCH Venture Partners V, L.P., as the sole general partner of ARCH Venture Fund V, L.P. and ARCH V Entrepreneurs Fund, L.P., may be deemed to beneficially own certain of the shares held of record by ARCH Venture Fund V, L.P. and ARCH V Entrepreneurs Fund, L.P., but disclaims beneficial ownership of such shares, in which it does not have an actual pecuniary interest. ARCH Venture Partners V, LLC, as the sole general partner of ARCH Venture Partners V, L.P., may be deemed to beneficially own certain of the shares held of record by ARCH Venture Fund V, L.P. and ARCH V Entrepreneurs Fund, L.P. but disclaims beneficial ownership of such shares, in which it does not have an actual pecuniary interest. Clinton Bybee, a member of the board of directors, is a managing director of ARCH Venture Partners V, LLC, and may be deemed to beneficially own certain of the shares held of record by ARCH Venture Fund V, L.P. and ARCH V Entrepreneurs Fund, L.P. Mr. Bybee disclaims beneficial ownership of all shares held of record by ARCH Venture Fund V, L.P. and ARCH V Entrepreneurs Fund, L.P., of which he does not have an actual pecuniary interest. By virtue of their relationship as affiliated entities who have overlapping general partners and managing directors, ARCH Venture Fund V, L.P., ARCH V Entrepreneurs Fund, L.P., ARCH Venture Partners V, L.P., ARCH Venture Partners V, LLC and Mr. Bybee may be deemed to share the voting and investment control of the record shares. Each share of Series 2 Preferred Stock automatically converted into 1.24996780424983 shares of Common Stock immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. 1,339,228 of these shares are held of record by ARCH Venture Fund V, L.P.; and 8,795 of these shares are held of record by ARCH V Entrepreneurs Fund, L.P. The warrant was automatically net exercised immediately prior to the completion of the Issuer's initial public offering of Common Stock. 1,378,986 of these shares are held of record by ARCH Venture Fund V, L.P.; and 9,062 of these shares are held of record by ARCH V Entrepreneurs Fund, L.P. 1,357,816 of these shares are held of record by ARCH Venture Fund V, L.P.; and 8,919 of these shares are held of record by ARCH V Entrepreneurs Fund, L.P. Mark McDonnell, as Attorney-in-Fact for Clinton Bybee 2016-08-30