0001209191-15-040942.txt : 20150511
0001209191-15-040942.hdr.sgml : 20150511
20150511123559
ACCESSION NUMBER: 0001209191-15-040942
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20141105
FILED AS OF DATE: 20150511
DATE AS OF CHANGE: 20150511
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Inogen Inc
CENTRAL INDEX KEY: 0001294133
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 326 BOLLAY DRIVE
CITY: GOLETA
STATE: CA
ZIP: 93117
BUSINESS PHONE: 805-562-0500
MAIL ADDRESS:
STREET 1: 326 BOLLAY DRIVE
CITY: GOLETA
STATE: CA
ZIP: 93117
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Versant Side Fund II, LP
CENTRAL INDEX KEY: 0001354307
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849672
BUSINESS ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Versant Venture Capital II, LP
CENTRAL INDEX KEY: 0001354131
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849673
BUSINESS ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: JAFFE ROSS A MD
CENTRAL INDEX KEY: 0001181338
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849675
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: COLELLA SAMUEL D
CENTRAL INDEX KEY: 0001201580
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849676
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MILDER DONALD B
CENTRAL INDEX KEY: 0001279660
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849677
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ATWOOD BRIAN G
CENTRAL INDEX KEY: 0001266567
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849679
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Versant Ventures II LLC
CENTRAL INDEX KEY: 0001354727
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849674
BUSINESS ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Versant Affiliates Fund II-A, LP
CENTRAL INDEX KEY: 0001354132
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849671
BUSINESS ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LINK WILLIAM J PHD
CENTRAL INDEX KEY: 0001228684
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 15849678
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
4/A
1
doc4a.xml
FORM 4/A SUBMISSION
X0306
4/A
2014-11-05
2014-11-07
0
0001294133
Inogen Inc
INGN
0001354727
Versant Ventures II LLC
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001354131
Versant Venture Capital II, LP
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001354307
Versant Side Fund II, LP
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001354132
Versant Affiliates Fund II-A, LP
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001266567
ATWOOD BRIAN G
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001228684
LINK WILLIAM J PHD
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001279660
MILDER DONALD B
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001201580
COLELLA SAMUEL D
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001181338
JAFFE ROSS A MD
ONE SANSOME STREET
SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
Common Stock
2014-11-05
4
J
0
3476
0.00
D
26061
I
See Footnote
Common Stock
2014-11-05
4
J
0
389136
0.00
D
2917544
I
See Footnote
Common Stock
2014-11-05
4
J
0
42216
0.00
A
42216
I
See Footnote
Common Stock
2014-11-05
4
J
0
42216
0.00
D
0
I
See Footnote
Common Stock
2014-11-05
4
J
0
194
0.00
A
9195
I
By Atwood Edminster Trust
Common Stock
2014-11-05
4
J
0
5594
0.00
A
14789
I
By Atwood Edminster Trust
Common Stock
2014-11-05
4
J
0
388
0.00
A
9584
I
By Colella Family Partners and Colella Family Trust UTA Dated 9/21/92
Common Stock
2014-11-05
4
J
0
5596
0.00
A
15180
I
By Colella Family Partners and Colella Family Trust UTA Dated 9/21/92
Common Stock
2014-11-05
4
J
0
243
0.00
A
9294
I
By The Jaffe Family Trust
Common Stock
2014-11-05
4
J
0
5595
0.00
A
14889
I
By The Jaffe Family Trust
Common Stock
2014-11-05
4
J
0
243
0.00
A
9294
I
By The Link Family Trust
Common Stock
2014-11-05
4
J
0
5595
0.00
A
14889
I
By The Link Family Trust
Common Stock
2014-11-05
4
J
0
486
0.00
A
3174
I
By Milder Community Property Trust
Common Stock
2014-11-05
4
J
0
1398
0.00
A
4572
I
By Milder Community Property Trust
Common Stock
2014-11-06
4
S
0
4238
24.5617
D
58495
I
See Footnote
Common Stock
2014-11-07
4
S
0
3150
23.9499
D
55345
I
See Footnote
Represents a pro-rata in-kind distribution of Common Stock of the Issuer for no consideration by Versant Side Fund II, L.P. ("VSF II") to its partners.
Shares held by VSF II. Versant Ventures II, LLC ("VV II") serves as the sole general partner of VSF II. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VV II and share voting and dispositive power over the shares held by VSF II, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
Represents a pro-rata in-kind distribution of Common Stock of the Issuer by Versant Venture Capital II, L.P. ("VVC II") without consideration to its partners.
Shares held by VVC II. VV II serves as the sole general partner of VVC II. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VV II and share voting and dispositive power over the shares held by VVC II, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
Represents a change in the form of ownership by virtue of the receipt of shares in the pro-rata distribution of Common Stock of the Issuer by VVC II.
The shares are held by VV II. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden and Barbara N. Lubash are directors and/or members of VV II and share voting and dispositive power over the shares held by VV II, however, each disclaim beneficial ownership of these shares except to the extent of their pecuniary interest therein.
Represents a pro-rata in-kind distibution of Common Stock of the Issuer by VV II without consideration to its members.
The shares are held by the Atwood-Edminster Trust dated 4/2/2000 (the "Trust") for the benefit of Brian G. Atwood. Brian G. Atwood is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
The shares are held by Colella Family Partners and Colella Family Trust UTA Dated 9/21/92 for the benefit of Samuel D. Colella. Samuel D. Colella is a general partner of Colella Family Partners and a trustee of Colella Family Trust UTA Dated 9/21/92. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
The shares are held by The Jaffe Family Trust (the "Trust") for the benefit of Ross A. Jaffe. Ross A. Jaffe is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
The shares are held by The Link Family Trust (the "Trust") for the benefit of William J. Link. William J. Link is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
The shares are held by the Milder Community Property Trust (the "Trust") for the benefit of Donald B. Milder. Donald B. Milder is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
Price reflected is the weighted-average sale price for shares sold. The range of the sale prices for the transaction was $24.13 and $24.87 per share. The Reporting Person undertakes to provide, upon request by the SEC staff, the Issuer, or security holder of the Issuer, full information regarding the number of shares sold at each sepate price.
Shares held by Versant Affiliates Fund II-A, L.P. ("VAF II-A"). VV II serves as the sole general partner of VAF II-A. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VV II and share voting and dispositive power over the shares held by VAF II-A, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
Price reflected is the weighted-average sale price for shares sold. The range of the sale prices for the transaction was $23.475 and $24.34 per share. The Reporting Person undertakes to provide, upon request by the SEC staff, the Issuer, or security holder of the Issuer, full information regarding the number of shares sold at each sepate price.
Filing 2 of 2
/s/ Robin L. Praeger
2015-05-07