-----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, GnxBp9Cl8xvLJGKYkZZbDe1DOuqWab1e01OsoLfUaGv0sCFTIOSdUsKN6kU416wY Nwy/5JiV4etIqGwCxdF2ng== 0001181431-10-054978.txt : 20101110 0001181431-10-054978.hdr.sgml : 20101110 20101110214126 ACCESSION NUMBER: 0001181431-10-054978 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101110 FILED AS OF DATE: 20101110 DATE AS OF CHANGE: 20101110 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: COMPLETE GENOMICS INC CENTRAL INDEX KEY: 0001361103 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMMERCIAL PHYSICAL & BIOLOGICAL RESEARCH [8731] IRS NUMBER: 203226545 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2071 STIERLIN COURT CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 BUSINESS PHONE: (650) 943-2843 MAIL ADDRESS: STREET 1: 2071 STIERLIN COURT CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Prospect Venture Partners III L P CENTRAL INDEX KEY: 0001311490 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34939 FILM NUMBER: 101181740 BUSINESS ADDRESS: STREET 1: 435 TASSO ST STREET 2: SUITE 200 CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: 650-327-8800 MAIL ADDRESS: STREET 1: 435 TASSO ST STREET 2: SUITE 200 CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Prospect Management Co. III, L.L.C. CENTRAL INDEX KEY: 0001331894 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34939 FILM NUMBER: 101181739 BUSINESS ADDRESS: STREET 1: 435 TASSO STREET STREET 2: SUITE 200 CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: 6503278800 MAIL ADDRESS: STREET 1: 435 TASSO STREET STREET 2: SUITE 200 CITY: PALO ALTO STATE: CA ZIP: 94301 3 1 rrd289926.xml FORM 3 X0203 3 2010-11-10 0 0001361103 COMPLETE GENOMICS INC GNOM 0001311490 Prospect Venture Partners III L P C/O PROSPECT VENTURE PARTNERS 435 TASSO STREET, SUITE 200 PALO ALTO CA 94301 0 0 1 0 0001331894 Prospect Management Co. III, L.L.C. 435 TASSO STREET SUITE 200 PALO ALTO CA 94301 0 0 1 0 Common Stcok, $0.001 par value 405542 I See Footnote (4) Series B Preferred Stock 0.00 Common Stock 601248 I See Footnote Series C Preferred Stock 0.00 Common Stock 160552 I See Footnote Series D Preferred Stock 0.00 Common Stock 674426 I See Footnote Series E Preferred Stock 0.00 Common Stock 807760 I See Footnote Warrant to Purchase Common Stock 1.50 2015-04-12 Common Stock 133938 I See Footnote Warrant to Purchase Common Stock 1.50 2015-06-22 Common Stock 51959 I See Footnote Warrant to Purchase Series D Preferred Stock 7.56 2014-02-13 Common Stock 29343 I See Footnote Warrant to Purchase Series D Preferred Stock 7.56 2014-04-06 Common Stock 31299 I See Footnote Warrant to Purchase Series D Preferred Stock 7.56 2014-06-12 Common Stock 10240 I See Footnote Warrant to Purchase Series D Preferred Stock 7.56 2014-08-05 Common Stock 990 I See Footnote Each share of Series B Preferred Stock will automatically convert into common stock upon the closing of the Issuer's initial public offering. Shares are reported on an "as converted" basis giving effect to the 5.926613 conversion ratio applicable to such shares. The securities are immediately convertible. The expiration date is not relevant to the conversion of these securities. The shares are owned by Prospect Venture Partners III, L.P. ("PVP III"). Prospect Management Co. III, L.L.C. ("PMC III") serves as the general partner of PVP III and possesses sole voting and investment control over the shares owned by PVP III and may be deemed to have indirect beneficial ownership of the shares held by PVP III. PMC III however owns no securities of the Issuer directly. The Reporting Person disclaims beneficial ownership of the shares reported herein, except to the extent of his proportionate pecuniary interest therein. Each share of Series C Preferred Stock will automatically convert into common stock upon the closing of the Issuer's initial public offering. Shares are reported on an "as converted" basis giving effect to the 8.241076 conversion ratio applicable to such shares. Each share of Series D and Series E Preferred Stock will automatically convert on a 1-for-1 basis into common stock upon the closing of the Issuer's initial public offering. The warrant is immediately exercisable. /s/ Managing Director, Prospect Management Co. III LLC, its General Partner, PROSPECT VENTURE PARTNERS III. L.P. 2010-11-10 /s/ Managing Director, PROSPECT MANAGEMENT CO. II, LLC 2010-11-10 -----END PRIVACY-ENHANCED MESSAGE-----