0001104659-14-018559.txt : 20140311
0001104659-14-018559.hdr.sgml : 20140311
20140311202904
ACCESSION NUMBER: 0001104659-14-018559
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140307
FILED AS OF DATE: 20140311
DATE AS OF CHANGE: 20140311
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ACELRX PHARMACEUTICALS INC
CENTRAL INDEX KEY: 0001427925
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 351 GALVESTON DRIVE
CITY: REDWOOD CITY
STATE: CA
ZIP: 94063
BUSINESS PHONE: 650-216-3500
MAIL ADDRESS:
STREET 1: 351 GALVESTON DRIVE
CITY: REDWOOD CITY
STATE: CA
ZIP: 94063
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KANEKO YASUNORI
CENTRAL INDEX KEY: 0001277503
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35068
FILM NUMBER: 14685922
MAIL ADDRESS:
STREET 1: 509 ROEHAMPTON
CITY: HILLS BOROUGH
STATE: CA
ZIP: 94010
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: 001-35068
FILM NUMBER: 14685923
MAIL ADDRESS:
STREET 1: 125 UNIVERSITY AVE.
STREET 2: C/O SKYLINE VENTURES
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Skyline Venture Management IV, LLC
CENTRAL INDEX KEY: 0001392103
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35068
FILM NUMBER: 14685924
BUSINESS ADDRESS:
STREET 1: 525 UNIVERSITY AVE.
STREET 2: SUITE 520
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: 650-462-5800
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVE.
STREET 2: SUITE 520
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Skyline Venture Partners Qualified Purchaser Fund IV L P
CENTRAL INDEX KEY: 0001324617
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35068
FILM NUMBER: 14685925
BUSINESS ADDRESS:
STREET 1: 125 UNIVERSITY AVE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
MAIL ADDRESS:
STREET 1: 125 UNIVERSITY AVE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
4
1
a4.xml
4
X0306
4
2014-03-07
1
0001427925
ACELRX PHARMACEUTICALS INC
ACRX
0001324617
Skyline Venture Partners Qualified Purchaser Fund IV L P
C/O SKYLINE PARTNERS
525 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
0
1
Former 10% Holder
0001392103
Skyline Venture Management IV, LLC
C/O SKYLINE PARTNERS
525 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
1
0
0001296771
Freund John Gordon
C/O SKYLINE PARTNERS
525 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
1
0
0001277503
KANEKO YASUNORI
C/O SKYLINE PARTNERS
525 UNIVERSITY AVENUE
PALO ALTO
CA
94301
0
0
1
0
Common Stock
2014-03-07
4
J
0
1300000
0
D
2871933
I
See footnote
Represents a pro-rata in-kind distribution by Skyline Venture Partners Qualified Purchaser Fund IV, L.P. ("SVP IV") without consideration to its limited and general partners.
The shares are held by SVP IV. John G. Freund, M.D. and Yasunori Kaneko, M.D. are the Managing Members of Skyline Venture Management IV, LLC, the general partner of SVP IV, and may be deemed to share voting and dispositive power over the shares held by SVP IV. Stephen Hoffman, M.D., Ph.D., one of the Issuer's directors, is a member of Skyline Venture Management IV, LLC and may be deemed to share voting and dispositive power with respect to the shares of Common Stock held by SVP IV. Each of Drs. Freund and Kaneko disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. Stephen Hoffman is a director of the Issuer and, accordingly, files separate Section 16 reports.
/s/ Karensa Kenny as attorney-in-fact Skyline Venture Partners Qualified Purchaser Fund IV, L.P
2014-03-11
/s/ Karensa Kenny as attorney-in-fact Skyline Venture Management IV, LLC
2014-03-11
/s/ Karensa Kenny as attorney-in-fact John G. Freund
2014-03-11
/s/ Karensa Kenny as attorney-in-fact Yasunori Kaneko
2014-03-11