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