0001144204-16-104561.txt : 20160524
0001144204-16-104561.hdr.sgml : 20160524
20160524170724
ACCESSION NUMBER: 0001144204-16-104561
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160523
FILED AS OF DATE: 20160524
DATE AS OF CHANGE: 20160524
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: PHASERX, INC.
CENTRAL INDEX KEY: 0001429386
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 204690620
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 410 WEST HARRISON STREET
STREET 2: SUITE 300
CITY: SEATTLE
STATE: WA
ZIP: 98119
BUSINESS PHONE: 206-805-6300
MAIL ADDRESS:
STREET 1: 410 WEST HARRISON STREET
STREET 2: SUITE 300
CITY: SEATTLE
STATE: WA
ZIP: 98119
FORMER COMPANY:
FORMER CONFORMED NAME: PHASERX INC
DATE OF NAME CHANGE: 20080311
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bolzon Bradley J PhD
CENTRAL INDEX KEY: 0001354345
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37772
FILM NUMBER: 161672573
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: Warden Charles M
CENTRAL INDEX KEY: 0001354802
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37772
FILM NUMBER: 161672574
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: ROBERTSON REBECCA B
CENTRAL INDEX KEY: 0001201585
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37772
FILM NUMBER: 161672575
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
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37772
FILM NUMBER: 161672576
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
4
1
v440802_4.xml
OWNERSHIP DOCUMENT
X0306
4
2016-05-23
0
0001429386
PHASERX, INC.
PZRX
0001266567
ATWOOD BRIAN G
C/O VERSANT VENTURES
ONE SANSOME STREET, SUITE 3630
SAN FRANCISCO
CA
94104
1
0
1
0
0001201585
ROBERTSON REBECCA B
C/O VERSANT VENTURES
ONE SANSOME STREET, SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001354802
Warden Charles M
C/O VERSANT VENTURES
ONE SANSOME STREET, SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
0001354345
Bolzon Bradley J PhD
C/O VERSANT VENTURES
ONE SANSOME STREET, SUITE 3630
SAN FRANCISCO
CA
94104
0
0
1
0
Common Stock
2016-05-23
4
S
0
435
0.01
D
8965
I
By Versant Side Fund III, L.P.
Common Stock
2016-05-23
4
S
0
1080
0.01
D
7885
I
By Versant Side Fund III, L.P.
Common Stock
2016-05-23
4
P
0
3523
5.00
A
11408
I
By Versant Side Fund III, L.P.
Common Stock
2016-05-23
4
S
0
73615
0.01
D
1517531
I
By Versant Venture Capital III, L.P.
Common Stock
2016-05-23
4
S
0
182914
0.01
D
1334617
I
By Versant Venture Capital III, L.P.
Common Stock
2016-05-23
4
P
0
596477
5.00
A
1931094
I
By Versant Venture Capital III, L.P.
Common stock held of record, respectively, by each of Versant Side Fund III, L.P. and Versant Venture Capital III, L.P., (the "Versant Venture Funds"). Versant Ventures III, LLC is the general partner of the Versant Venture Funds and has voting and dispositive control over securities held by the Versant Venture Funds. Brian G. Atwood, Samuel D. Colella, Ross Jaffe, M.D., William J. Link, Barbara N. Lubash, Donald B. Milder, Bradley J. Bolzon, Charles M. Warden, Robin L. Praeger and Rebecca R. Robertson are the managing directors of Versant Ventures III, LLC and are deemed to have voting and dispositive power over the shares and may be deemed to beneficially own shares held by the Versant Venture Funds. Brian G. Atwood is a managing member of and owns an interest in Versant Ventures III, LLC.
Accordingly, Brian G. Atwood may be deemed to beneficially own the securities held by the Versant Venture Funds. Each of Brian G. Atwood, Samuel D. Colella, Ross Jaffe, M.D., William J. Link, Barbara N. Lubash, Donald B. Milder, Bradley J. Bolzon, Charles M. Warden, Robin L. Praeger and Rebecca R. Robertson disclaims beneficial ownership of these securities except to the extent of their pecuniary interest therein.
This Form 4 is the second of two filings by Brian G. Atwood. Versant Side Fund III, L.P., Versant Venture Capital III, L.P., Versant Ventures III, LLC, Samuel D. Colella, Ross Jaffe, M.D., William J. Link, Barbara N. Lubash, Donald B. Milder, and Robin L. Praeger (the "Other Filers") are also reporting persons. Since the SEC's filing system will not accept CIK and CCC codes from more than ten joint filers of a report, the Other Filers have filed a separate Form 4 that relates to the same securities reported herein. Thus, in total, there are 13 joint filers: the Other Filers and each person that is a signatory to this Form 4.
/s/ ROBIN L. PRAEGER as Attorney-in-Fact for Brian Atwood
2016-05-24
/s/ ROBIN L. PRAEGER, as Attorney-in-Fact for Bradley J. Bolzon
2016-05-24
/s/ ROBIN L. PRAEGER, as Attorney-in-Fact for Charles M. Warden
2016-05-24
/s/ ROBIN L. PRAEGER, as Attorney-in-Fact for Rebecca R. Robertson
2016-05-24