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