0001209191-16-126262.txt : 20160607 0001209191-16-126262.hdr.sgml : 20160607 20160607163559 ACCESSION NUMBER: 0001209191-16-126262 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160607 FILED AS OF DATE: 20160607 DATE AS OF CHANGE: 20160607 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hatteras Venture Partners IV SBIC, LP CENTRAL INDEX KEY: 0001675232 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37783 FILM NUMBER: 161701673 BUSINESS ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 BUSINESS PHONE: 919-484-0730 MAIL ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Thorp Clay CENTRAL INDEX KEY: 0001592380 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37783 FILM NUMBER: 161701674 MAIL ADDRESS: STREET 1: C/O HATTERAS VENTURE PARTNERS III, LP STREET 2: 280 S. MANGUM ST., SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INGRAM ROBERT ALEXANDER CENTRAL INDEX KEY: 0001219890 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37783 FILM NUMBER: 161701675 MAIL ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 FORMER NAME: FORMER CONFORMED NAME: INGRAM ROBERT A DATE OF NAME CHANGE: 20030222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEE KENNETH B JR CENTRAL INDEX KEY: 0001208570 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37783 FILM NUMBER: 161701676 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Reed Douglas MD CENTRAL INDEX KEY: 0001291262 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37783 FILM NUMBER: 161701677 MAIL ADDRESS: STREET 1: C/O VECTOR FUND MANAGEMENT STREET 2: 1751 LAKE COOK ROAD, SUITE 350 CITY: DEERFIELD STATE: IL ZIP: 60015 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Crumpler John CENTRAL INDEX KEY: 0001674107 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37783 FILM NUMBER: 161701678 MAIL ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hatteras Venture Advisors IV SBIC, LLC CENTRAL INDEX KEY: 0001675236 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37783 FILM NUMBER: 161701679 BUSINESS ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 BUSINESS PHONE: 919-484-0730 MAIL ADDRESS: STREET 1: 280 S. MANGUM STREET STREET 2: SUITE 350 CITY: DURHAM STATE: NC ZIP: 27701 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Clearside Biomedical, Inc. CENTRAL INDEX KEY: 0001539029 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 452437375 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1220 OLD ALPHARETTA RD STREET 2: SUITE 300 CITY: ALPHARETTA STATE: GA ZIP: 30005 BUSINESS PHONE: 678-270-4005 MAIL ADDRESS: STREET 1: 1220 OLD ALPHARETTA RD STREET 2: SUITE 300 CITY: ALPHARETTA STATE: GA ZIP: 30005 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-06-07 0 0001539029 Clearside Biomedical, Inc. CLSD 0001675236 Hatteras Venture Advisors IV SBIC, LLC 280 S. MANGUM ST., SUITE 350 DURHAM NC 27701 0 0 1 0 0001674107 Crumpler John C/O HATTERAS VENTURES 280 S. MANGUM ST., SUITE 350 DURHAM NC 27701 0 0 1 0 0001291262 Reed Douglas MD C/O HATTERAS VENTURES 280 S. MANGUM ST., SUITE 350 DURHAM NC 27701 0 0 1 0 0001208570 LEE KENNETH B JR C/O HATTERAS VENTURES 280 S. MANGUM ST., SUITE 350 DURHAM NC 27701 0 0 1 0 0001219890 INGRAM ROBERT ALEXANDER C/O HATTERAS VENTURES 280 S. MANGUM ST., SUITE 350 DURHAM NC 27701 0 0 1 0 0001592380 Thorp Clay C/O HATTERAS VENTURES 280 S. MANGUM ST., SUITE 350 DURHAM NC 27701 1 0 1 0 0001675232 Hatteras Venture Partners IV SBIC, LP 280 S. MANGUM ST., SUITE 350 DURHAM NC 27701 0 0 1 0 Common Stock 2016-06-07 4 C 0 1598223 A 1654248 I By Hatteras Venture Partners IV SBIC, LP Common Stock 2016-06-07 4 X 0 21705 0.022 A 1675953 I By Hatteras Venture Partners IV SBIC, LP Common Stock 2016-06-07 4 S 0 69 7.00 D 1675884 I By Hatteras Venture Partners IV SBIC, LP Common Stock 2016-06-07 4 P 0 414286 7.00 A 2090170 I By Hatteras Venture Partners IV SBIC, LP Series A Preferred Stock 2016-06-07 4 C 0 2035908 0.00 D Common Stock 925412 0 I By Hatteras Venture Partners IV SBIC, LP Series A-1 Preferred Stock 2016-06-07 4 C 0 689388 0.00 D Common Stock 313358 0 I By Hatteras Venture Partners IV SBIC, LP Series B Preferred Stock 2016-06-07 4 C 0 432941 0.00 D Common Stock 196791 0 I By Hatteras Venture Partners IV SBIC, LP Series C Preferred Stock 2016-06-07 4 C 0 337897 0.00 D Common Stock 162662 0 I By Hatteras Venture Partners IV SBIC, LP Warrant to Purchase Common Stock (right to buy) 0.022 2016-06-07 4 X 0 21705 0.00 D 2014-04-28 Common Stock 21705 0 I By Hatteras Venture Partners IV SBIC, LP The total represents shares received upon conversion of shares of Series A Preferred Stock, Series A-1 Preferred Stock, Series B Preferred Stock and Series C Preferred Stock. Effective immediately prior to the closing of the Issuer's initial public offering of its common stock, each share of Series A Preferred Stock, Series A-1 Preferred Stock and Series B Preferred Stock automatically converted into 0.454545 shares of the Issuer's common stock, and each share of Series C Preferred Stock automatically converted into 0.4814 shares of the Issuer's common stock. The Preferred Stock had no expiration date. The reportable securities are owned directly by Hatteras Venture Partners IV SBIC, LP ("HVP IV"). Hatteras Venture Advisors IV SBIC, LLC is the general partner of HVP IV (the "GP"). The securities directly held by HVP IV are indirectly held by the individual managing members of GP (each, a "GP Managing Member" and collectively, the "GP Managing Members"). The GP Managing Members are John Crumpler, Clay Thorp, Ken Lee, Douglas Reed and Robert Ingram. The GP Managing Members may share voting and dispositive power over the securities directly held by HVP IV. Each GP Managing Member disclaims beneficial ownership of these securities and this report is not an admission that any GP Managing Member is a beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of his pecuniary interest therein. On June 7, 2016, HVP IV exercised a warrant to purchase 21,705 shares of Issuer's common stock for $0.022 per share. HVP IV paid the exercise price on a cashless basis, resulting in the Issuer's withholding of an aggregate of 69 of the warrant shares to pay the exercise price and issuing to the HVP IV the remaining 21,636 shares. This warrant would have expired upon the closing of the Issuer's initial public offering. /s/ Brian F. Leaf, Attorney-in-Fact for Hatteras Venture Advisors IV SBIC, LLC 2016-06-07 /s/ Brian F. Leaf, Attorney-in-Fact for John Crumpler 2016-06-07 /s/ Brian F. Leaf, Attorney-in-Fact for Douglas Reed 2016-06-07 /s/ Brian F. Leaf, Attorney-in-Fact for Kenneth Lee 2016-06-07 /s/ Brian F. Leaf, Attorney-in-Fact for Robert Ingram 2016-06-07 /s/ Brian F. Leaf, Attorney-in-Fact for Clay Thorp 2016-06-07 /s/ Brian F. Leaf, Attorney-in-Fact for Hatteras Venture Advisors IV SBIC, LLC, the general partner of Hatteras Venture Partners IV SBIC, LP 2016-06-07