0001192482-19-000438.txt : 20191114
0001192482-19-000438.hdr.sgml : 20191114
20191114161250
ACCESSION NUMBER: 0001192482-19-000438
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191112
FILED AS OF DATE: 20191114
DATE AS OF CHANGE: 20191114
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Freund John Gordon
CENTRAL INDEX KEY: 0001296771
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37372
FILM NUMBER: 191220284
MAIL ADDRESS:
STREET 1: 125 UNIVERSITY AVE.
STREET 2: C/O SKYLINE VENTURES
CITY: PALO ALTO
STATE: CA
ZIP: 94301
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: COLLEGIUM PHARMACEUTICAL, INC
CENTRAL INDEX KEY: 0001267565
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: VA
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 100 TECHNOLOGY CENTER DRIVE
CITY: STOUGHTON
STATE: MA
ZIP: 02072
BUSINESS PHONE: 781-713-3699
MAIL ADDRESS:
STREET 1: 100 TECHNOLOGY CENTER DRIVE
CITY: STOUGHTON
STATE: MA
ZIP: 02072
FORMER COMPANY:
FORMER CONFORMED NAME: COLLEGIUM PHARMACEUTICAL INC
DATE OF NAME CHANGE: 20031020
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2019-11-12
0001267565
COLLEGIUM PHARMACEUTICAL, INC
COLL
0001296771
Freund John Gordon
C/O SKYLINE VENTURE PARTNERS V, L.P.
525 UNIVERSITY AVE.
PALO ALTO
CA
94301
1
0
0
0
Common Stock
2019-11-12
4
J
0
575000
0
D
574916
I
By: Skyline Venture Partners V, L.P.
Common Stock
2019-11-12
4
J
0
8423
0
A
34788
I
By: John Freund Family Partnership IV, L.P.
Common Stock
6960
D
Represents a pro rata in-kind distribution of the shares by Skyline Venture Partners V, L.P. without consideration to its limited and general partners.
The shares are held by Skyline Venture Partners V, L.P. The general partner of Skyline Venture Partners V, L.P. is Skyline Venture Management V, LLC. John G. Freund and Yasunori Kaneko are managers of Skyline Venture Management V, LLC. These individuals share voting and investment power over the shares held by Skyline Venture Management, LLC. Dr. Freund disclaims beneficial ownership of all the shares held by Skyline Venture Partners V, L.P. except to the extent of his proportionate pecuniary interest therein.
Represents a pro rata in-kind distribution of the shares by Skyline Venture Partners V, L.P. without consideration to the reporting person.
The shares are held by the John Freund Family Partnership IV, L.P. ("Freund LP"). The reporting person is the trustee and beneficiary of the The John G. Freund Revocable Trust u/a/d 6/26/01 which serves as the general partner of Freund LP. The reporting person disclaims beneficial ownership of the shares held by Freund LP except to the extent of his proportionate pecuniary interest therein.
/s/ Paul Brannelly as Attorney-In-Fact For John G. Freund, MD
2019-11-14