FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 11/19/2014 |
3. Issuer Name and Ticker or Trading Symbol
Neothetics, Inc. [ NEOT ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 3,934 | I | Alta Partners VIII, LP(1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Preferred Stock | (2) | (2) | Common Stock | 750,000 | (2) | I | Alta Partners VIII, LP(1) |
Series B Preferred Stock | (2) | (2) | Common Stock | 6,216,215 | (2) | I | Alta Partners VIII, LP(1) |
Series B-2 Preferred Stock | (2) | (2) | Common Stock | 2,201,220 | (2) | I | Alta Partners VIII, LP(1) |
Series C Preferred Stock | (2) | (2) | Common Stock | 4,489,065 | (2) | I | Alta Partners VIII, LP(1) |
Warrant | 09/30/2011 | 09/30/2018 | Series B-2 Preferred Stock | 432,432 | $1.85 | I | Alta Partners VIII, LP(1) |
Warrant | 12/01/2011 | 12/01/2018 | Series C Preferred Stock | 707,142 | $1.4 | I | Alta Partners VIII, LP(1) |
Warrant | 07/25/2012 | 07/25/2019 | Series C Preferred Stock | 214,285 | $1.4 | I | Alta Partners VIII, LP(1) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. The securities are held by Alta Partners VIII, L.P. ("APVIII"). Alta Partners Manegment VIII, LLC ("APMVIII") is the general partner of APVIII. Guy Nohra, Daniel Janney and Farah Champsi are managing directors of APMVIII and exercise shared voting and investment power with respect to the shares owned by APVIII. Each of the reporting persons disclaims beneficial ownership of such securities, except to the extent of his, her or its proportionate pecuniary interest therein. |
2. Immediately prior to but contingent upon the closing of the initial public offering of the Issuer's Common Stock, all outstanding shares of Preferred Stock will be automatically converted, for no additional consideration, into shares of the Issuer's Common Stock. The Preferred Stock will convert pursuant to the applicable conversion ratio, as listed in the Amended and Restated Certificate of Incorporation of the Issuer, and reflect a 6.1-for-1 stock split of the Issuer's Common Stock which occurred on November 7, 2014. |
Remarks: |
/s/ Daniel Janney | 11/19/2014 | |
Larry Randall, CFO | 11/18/2014 | |
Guy Nohra | 11/19/2014 | |
Farah Champsi | 11/19/2014 | |
Larry Randall, CFO | 11/19/2014 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |