-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, OsoFXPmAOJ9Jy6qp2jxW5U8ow36Oz+5egnskBj4fWE9dbBuGPKQXt+QWwmdH9Y03 zYfoWpPjzVfzjNAin2hHTA== 0001209191-10-057212.txt : 20101129 0001209191-10-057212.hdr.sgml : 20101129 20101129193921 ACCESSION NUMBER: 0001209191-10-057212 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101129 FILED AS OF DATE: 20101129 DATE AS OF CHANGE: 20101129 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BOCK LOUIS C CENTRAL INDEX KEY: 0001279735 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34962 FILM NUMBER: 101220237 MAIL ADDRESS: STREET 1: C/O BANKAMERICA VENTURES STREET 2: 950 TOWER LANE STE 700 CITY: FOSTER CITY STATE: CA ZIP: 94404 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ZOGENIX, INC. CENTRAL INDEX KEY: 0001375151 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 205300780 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 12671 HIGH BLUFF DRIVE STREET 2: SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92130 BUSINESS PHONE: (858) 259-1165 MAIL ADDRESS: STREET 1: 12671 HIGH BLUFF DRIVE STREET 2: SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92130 FORMER COMPANY: FORMER CONFORMED NAME: ZOGENIX INC DATE OF NAME CHANGE: 20060911 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2010-11-29 0 0001375151 ZOGENIX, INC. ZGNX 0001279735 BOCK LOUIS C 950 TOWER LANE, SUITE 700 FOSTER CITY CA 94404 1 0 1 0 Common Stock 2010-11-29 4 C 0 1400000 A 1400000 I See FN Common Stock 2010-11-29 4 C 0 831901 A 2231901 I See FN Common Stock 2010-11-29 4 P 0 589645 4.00 A 2821546 I See FN Common Stock 2010-11-29 4 P 0 1250000 4.00 A 4071546 I See FN Series A-1 Convertible Preferred Stock 2010-11-29 4 C 0 14000000 0.00 D Common Stock 1400000 0 I See FN Series B Convertible Preferred Stock 2010-11-29 4 C 0 8319024 0.00 D Common Stock 831901 0 I See FN Represents shares of common stock acquired upon the automatic conversion of Series A-1 Preferred Stock upon the closing of the Issuer's initial public offering of common stock. Each share of Series A-1 Preferred Stock converted into 0.1 shares of common stock. The securities are held directly by Scale Venture Partners II, LP ("Scale Partners"). The General Partner of Scale Partners is Scale Venture Management II, LLC ("Scale Management"). The Reporting Person is a managing member of Scale Management and shares voting and investment power with respect to these securities with four other managing members of Scale Management. The Reporting Person disclaims beneficial ownership with respect to these securities except to the extent of his pecuniary interest therein. Represents shares of common stock acquired upon the automatic conversion of Series B Preferred Stock upon the closing of the Issuer's initial public offering of common stock. Each share of Series B Preferred Stock converted into 0.1 shares of common stock. The common stock was acquired upon conversion of a convertible promissory note exempt from the definition of a derivative security because the conversion price did not become fixed until automatic conversion at the time of the closing of the Issuer's initial public offering. Represents shares of common stock acquired by Scale Partners upon the conversion of convertible promissory notes issued to Scale Partners in July 2010. The outstanding principal amount and accrued but unpaid interest thereon was automatically converted into shares of common stock of the Issuer upon the consummation of an initial public offering of the Issuer's common stock at a conversion price equal to $4.00, which was the initial public offering price per share. These securities are preferred stock of the Issuer and did not have an expiration date. Prior to the Issuer's initial public offering of common stock, the securities were convertible at any time at the election of the holder. The securities automatically converted into shares of common stock upon the closing of the Issuer's initial public offering of common stock. /s/ Louis Bock 2010-11-29 -----END PRIVACY-ENHANCED MESSAGE-----