0001140361-14-037156.txt : 20141002
0001140361-14-037156.hdr.sgml : 20141002
20141002174103
ACCESSION NUMBER: 0001140361-14-037156
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20141002
FILED AS OF DATE: 20141002
DATE AS OF CHANGE: 20141002
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Dermira, Inc.
CENTRAL INDEX KEY: 0001557883
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 273267680
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2055 WOODSIDE ROAD
STREET 2: SUITE 270
CITY: REDWOOD CITY
STATE: CA
ZIP: 94061
BUSINESS PHONE: 650 421 7200
MAIL ADDRESS:
STREET 1: 2055 WOODSIDE ROAD
STREET 2: SUITE 270
CITY: REDWOOD CITY
STATE: CA
ZIP: 94061
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bay City Capital Fund V Co-Investment Fund, L.P.
CENTRAL INDEX KEY: 0001409813
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36668
FILM NUMBER: 141137692
BUSINESS ADDRESS:
STREET 1: 750 BATTERY STREET
STREET 2: Suite 400
CITY: San Francisco
STATE: CA
ZIP: 94111
BUSINESS PHONE: (415) 676-3830
MAIL ADDRESS:
STREET 1: 750 BATTERY STREET
STREET 2: Suite 400
CITY: San Francisco
STATE: CA
ZIP: 94111
FORMER NAME:
FORMER CONFORMED NAME: Bay City Capital Fund V Co-Investment Fund LP
DATE OF NAME CHANGE: 20070815
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bay City Capital Fund V, L.P.
CENTRAL INDEX KEY: 0001401826
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36668
FILM NUMBER: 141137693
BUSINESS ADDRESS:
STREET 1: 750 Battery Street
STREET 2: Suite 400
CITY: San Francisco
STATE: CA
ZIP: 94111
BUSINESS PHONE: 415-676-3830
MAIL ADDRESS:
STREET 1: 750 Battery Street
STREET 2: Suite 400
CITY: San Francisco
STATE: CA
ZIP: 94111
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bay City Capital Management V LLC
CENTRAL INDEX KEY: 0001461543
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36668
FILM NUMBER: 141137694
BUSINESS ADDRESS:
STREET 1: 750 BATTERY STREET, SUITE 400
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
BUSINESS PHONE: 415-676-3830
MAIL ADDRESS:
STREET 1: 750 BATTERY STREET, SUITE 400
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BAY CITY CAPITAL LLC
CENTRAL INDEX KEY: 0001288452
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36668
FILM NUMBER: 141137695
BUSINESS ADDRESS:
STREET 1: 750 BATTERY STREET STE 400
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
BUSINESS PHONE: 415.676.3830
MAIL ADDRESS:
STREET 1: 750 BATTERY STREET STE 400
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
FORMER NAME:
FORMER CONFORMED NAME: BAY CITY CAPITAL FUND LLC
DATE OF NAME CHANGE: 20040423
3
1
doc1.xml
FORM 3
X0206
3
2014-10-02
0
0001557883
Dermira, Inc.
DERM
0001288452
BAY CITY CAPITAL LLC
750 BATTERY STREET STE 400
SAN FRANCISCO
CA
94111
1
0
1
0
0001461543
Bay City Capital Management V LLC
750 BATTERY STREET, SUITE 400
SAN FRANCISCO
CA
94111
0
0
1
0
0001401826
Bay City Capital Fund V, L.P.
750 BATTERY STREET
SUITE 400
SAN FRANCISCO
CA
94111
0
0
1
0
0001409813
Bay City Capital Fund V Co-Investment Fund, L.P.
750 BATTERY STREET
SUITE 400
SAN FRANCISCO
CA
94111
0
0
1
0
Common Stock
16918
I
See footnotes
Common Stock
322
I
See footnotes
Series A Preferred Stock
0
Common Stock
2337590
I
See footnotes
Series A Preferred Stock
0
Common Stock
44545
I
See footnotes
Series B Preferred Stock
0
Common Stock
643066
I
See footnotes
Series B Preferred Stock
0
Common Stock
12254
I
See footnotes
Series C Preferred Stock
0
Common Stock
375681
I
See footnotes
Series C Preferred Stock
0
Common Stock
7159
I
See footnotes
Bay City Capital LLC, a Delaware limited liability company ("BCC"), Bay City Capital Management V LLC, a Delaware limited liability company ("Management V"), Bay City Capital Fund V, L.P., a Delaware limited partnership ("Fund V"), and Bay City Capital Fund V Co-Investment Fund, L.P., a Delaware limited partnership ("Co-Investment V") are deemed to be a "group" for the purposes of Section 13(d) under the Securities Exchange Act of 1934. Management V is the general partner of Fund V and Co-Investment V and has sole voting and dispositive power with respect to the securities held by Fund V and Co-Investment V. BCC, the manager of Management V, is also an advisor to Fund V and Co-Investment V and has sole voting and dispositive power with respect to the securities held by Fund V and Co-Investment V. Fred Craves, a Managing Director of BCC, is a member of the Issuer's Board of Directors.
Represent securities held by Fund V, including indirect interests of BCC and Management V. BCC and Management V each disclaims beneficial ownership with respect to these securities, except to the extent of their pecuniary interest therein.
Represent securities held by Co-Investment V, including indirect interests of BCC and Management V. BCC and Management V each disclaims beneficial ownership with respect to these securities, except to the extent of their pecuniary interest therein.
Each share of Preferred Stock will be automatically converted into one (1) share of Common Stock, for no additional consideration, immediately prior to the consummation of the Issuer's initial public offering, and has no expiration date.
Bay City Capital LLC /s/ Fred Craves, Managing Director
2014-10-02
Bay City Capital Management V, LLC By: Bay City Capital LLC its Manager /s/ Fred Craves, Managing Director
2014-10-02
Bay City Capital Fund V, L.P. By: Bay City Capital Management V, LLC its General Partner By: Bay City Capital LLC its Manager /s/ Fred Craves, Managing Director
2014-10-02
Bay City Capital Fund V Co-Investment Fund, L.P. By: Bay City Capital Management V, LLC its General Partner By: Bay City Capital LLC its Manager /s/ Fred Craves, Managing Director
2014-10-02