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