0001209191-15-041604.txt : 20150512
0001209191-15-041604.hdr.sgml : 20150512
20150512160430
ACCESSION NUMBER: 0001209191-15-041604
CONFORMED SUBMISSION TYPE: 3/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150506
FILED AS OF DATE: 20150512
DATE AS OF CHANGE: 20150512
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: 780 DEDHAM STREET, SUITE 800
CITY: CANTON
STATE: MA
ZIP: 02021
BUSINESS PHONE: 781-713-3699
MAIL ADDRESS:
STREET 1: 780 DEDHAM STREET, SUITE 800
CITY: CANTON
STATE: MA
ZIP: 02021
FORMER COMPANY:
FORMER CONFORMED NAME: COLLEGIUM PHARMACEUTICAL INC
DATE OF NAME CHANGE: 20031020
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KANEKO YASUNORI
CENTRAL INDEX KEY: 0001277503
FILING VALUES:
FORM TYPE: 3/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37372
FILM NUMBER: 15854447
MAIL ADDRESS:
STREET 1: 509 ROEHAMPTON
CITY: HILLS BOROUGH
STATE: CA
ZIP: 94010
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Skyline Venture Management V, LLC
CENTRAL INDEX KEY: 0001434887
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37372
FILM NUMBER: 15854448
BUSINESS ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: 650-475-0144
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Skyline Venture Partners V LP
CENTRAL INDEX KEY: 0001419187
STATE OF INCORPORATION: DE
FILING VALUES:
FORM TYPE: 3/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37372
FILM NUMBER: 15854449
BUSINESS ADDRESS:
STREET 1: 525 University Avenue
STREET 2: Suite 520
CITY: Palo Alto
STATE: CA
ZIP: 94301
MAIL ADDRESS:
STREET 1: 525 University Avenue
STREET 2: Suite 520
CITY: Palo Alto
STATE: CA
ZIP: 94301
3/A
1
doc3a.xml
FORM 3/A SUBMISSION
X0206
3/A
2015-05-06
2015-05-11
0
0001267565
COLLEGIUM PHARMACEUTICAL, INC
COLL
0001419187
Skyline Venture Partners V LP
525 UNIVERSITY AVENUE, SUITE 610
PALO ALTO
CA
94301
0
0
1
0
0001434887
Skyline Venture Management V, LLC
525 UNIVERSITY AVENUE, SUITE 610
PALO ALTO
CA
94301
0
0
1
0
0001277503
KANEKO YASUNORI
525 UNIVERSITY AVENUE, SUITE 610
PALO ALTO
CA
94301
0
0
1
0
Series B Convertible Preferred Stock
Common Stock
1552795
I
see footnote
Series C Convertible Preferred Stock
Common Stock
382323
I
see footnote
Series D Convertible Preferred Stock
Common Stock
852423
I
see footnote
All series of Convertible Preferred Stock will automatically convert into Collegium Pharmaceutical, Inc. common stock on a 1-for-6.9 basis immediately prior to the closing of the initial public offering and have no expiration date.
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 and disclaim beneficial ownership of all the shares held by Skyline Venture Partners V, L.P. except to the extent of their proportionate pecuniary interest therein. Dr. Freund is a director of the Issuer and, accordingly, files separate Section 16 reports.
The original filing was submitted using the the wrong CIK for the Issuer.
/s/ Kerensa Kenny, Attorney-in-Fact
2015-05-12