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