0001209191-15-039027.txt : 20150505
0001209191-15-039027.hdr.sgml : 20150505
20150505175629
ACCESSION NUMBER: 0001209191-15-039027
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150505
FILED AS OF DATE: 20150505
DATE AS OF CHANGE: 20150505
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HTG MOLECULAR DIAGNOSTICS, INC
CENTRAL INDEX KEY: 0001169987
STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826]
IRS NUMBER: 860912294
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3430 E. GLOBAL LOOP
CITY: TUCSON
STATE: AZ
ZIP: 85706
BUSINESS PHONE: 877-289-2615
MAIL ADDRESS:
STREET 1: 3430 E. GLOBAL LOOP
CITY: TUCSON
STATE: AZ
ZIP: 85706
FORMER COMPANY:
FORMER CONFORMED NAME: HTG MOLECULAR DIAGNOSTICS INC
DATE OF NAME CHANGE: 20110523
FORMER COMPANY:
FORMER CONFORMED NAME: HIGH THROUGHPUT GENOMICS INC
DATE OF NAME CHANGE: 20020326
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FSV II-B LP
CENTRAL INDEX KEY: 0001433420
STATE OF INCORPORATION: DE
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37369
FILM NUMBER: 15834389
BUSINESS ADDRESS:
STREET 1: C/O FLETCHER SPAGHT INC
STREET 2: 222 BERKELEY STREET
CITY: BOSTON
STATE: MA
ZIP: 02116
BUSINESS PHONE: 617-247-6700
MAIL ADDRESS:
STREET 1: C/O FLETCHER SPAGHT INC
STREET 2: 222 BERKELEY STREET
CITY: BOSTON
STATE: MA
ZIP: 02116
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FSV II LP
CENTRAL INDEX KEY: 0001384327
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37369
FILM NUMBER: 15834390
BUSINESS ADDRESS:
STREET 1: 222 BERKLEY ST
CITY: BOSTON
STATE: MA
ZIP: 02116
MAIL ADDRESS:
STREET 1: 222 BERKLEY ST
CITY: BOSTON
STATE: MA
ZIP: 02116
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Fletcher Spaght Ventures II LP
CENTRAL INDEX KEY: 0001384348
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37369
FILM NUMBER: 15834391
BUSINESS ADDRESS:
STREET 1: C/O FLETCHER SPAGHT INC
STREET 2: 222 BERKLEY ST
CITY: BOSTON
STATE: MA
ZIP: 02116
MAIL ADDRESS:
STREET 1: C/O FLETCHER SPAGHT INC
STREET 2: 222 BERKLEY ST
CITY: BOSTON
STATE: MA
ZIP: 02116
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2015-05-05
0
0001169987
HTG MOLECULAR DIAGNOSTICS, INC
HTGM
0001384348
Fletcher Spaght Ventures II LP
222 BERKELEY STREET
BOSTON
MA
02116
0
0
1
0
0001384327
FSV II LP
222 BERKELEY STREET
BOSTON
MA
02116
0
0
1
0
0001433420
FSV II-B LP
222 BERKELEY STREET
BOSTON
MA
02116
0
0
1
0
Series E Convertible Preferred Stock Warrant (right to buy)
0.2189
2015-01-14
2022-01-14
Series E Convertible Preferred Stock
861751
D
Series E Convertible Preferred Stock Warrant (right to buy)
0.2189
2015-01-14
2022-01-14
Series E Convertible Preferred Stock
410454
I
By FSV II-B, L.P.
Series E Convertible Preferred Stock Warrant (right to buy)
0.2189
2015-01-14
2022-01-14
Series E Convertible Preferred Stock
86783
I
By FSV II, L.P.
Series D Convertible Preferred Stock
0.00
Common Stock
156453
D
Series D Convertible Preferred Stock
0.00
Common Stock
74519
I
By FSV II-B, L.P.
Series D Convertible Preferred Stock
0.00
Common Stock
15755
I
By FSV II, L.P.
Series E Convertible Preferred Stock
0.00
Common Stock
35966
D
Series E Convertible Preferred Stock
0.00
Common Stock
17130
I
By FSV II-B, L.P
Series E Convertible Preferred Stock
0.00
Common Stock
3622
I
By FSV II, L.P.
Share numbers and exercise price do not give effect to the 1 for 107.39 reverse stock split of the Issuer's Common Stock effected on April 27, 2015, which will be effective for the Preferred Stock upon its conversion to Common Stock immediately prior to the closing of the Issuer's initial public offering.
The shares of Series D Convertible Preferred Stock have no expiration date and are convertible at any time at the election of the holder without payment of further consideration. Each share of Series D Convertible Preferred Stock will automatically convert on a 1 for 107.39 basis into shares of Common Stock upon the closing of the Issuer's initial public offering.
Share numbers assume or give effect to the 1 for 107.39 reverse stock split of the Issuer's Common Stock effected on April 27, 2015, which will be effective for the Preferred Stock upon its conversion to Common Stock immediately prior to the closing of the Issuer's initial public offering.
The shares of Series E Convertible Preferred Stock have no expiration date and are convertible at any time at the election of the holder without payment of further consideration. Each share of Series E Convertible Preferred Stock will automatically convert on a 1 for 107.39 basis into shares of Common Stock upon the closing of the Issuer's initial public offering.
/s/ Fletcher Spaght Ventures II, L.P.
By: Fletcher Spaght Associates II, L.P., its General Partner
By: FSA II, LLC, its General Partner
By: Linda Tufts, Managing Member
2015-05-05
/s/ FSV II, L.P.; By: Fletcher Spaght Associates II, LP, its General Partner; By: FSA II, LLC, its General Partner; By Linda Tufts, Managing Member
2015-05-05
/s/ FSV II-B, L.P.;By: Fletcher Spaght Associates II-B, LLC, its General Partner; By: FSA II, LLC, its Manager; By Linda Tufts, Managing Member
2015-05-05