0001012975-14-000687.txt : 20141029 0001012975-14-000687.hdr.sgml : 20141029 20141029165642 ACCESSION NUMBER: 0001012975-14-000687 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141027 FILED AS OF DATE: 20141029 DATE AS OF CHANGE: 20141029 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PROTEON THERAPEUTICS INC CENTRAL INDEX KEY: 0001359931 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 200 WEST STREET CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: 781-890-0102 MAIL ADDRESS: STREET 1: 200 WEST STREET CITY: WALTHAM STATE: MA ZIP: 02451 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: O'Leary Brendan CENTRAL INDEX KEY: 0001500269 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36694 FILM NUMBER: 141180761 MAIL ADDRESS: STREET 1: C/O PRISM VENTURES PARTNERS V, L.P. STREET 2: 117 KENDRICK STREET, SUITE 200 CITY: NEEDHAM STATE: MA ZIP: 02494 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2014-10-27 0001359931 PROTEON THERAPEUTICS INC PRTO 0001500269 O'Leary Brendan C/O PRISM VENTURE PARTNERS 75 SECOND AVENUE, SUITE 210 NEEDHAM MA 02494 1 0 0 0 Common Stock 2014-10-27 4 C 0 374921 A 374921 I See footnote Common Stock 2014-10-27 4 C 0 180014 A 554935 I See footnote Common Stock 2014-10-27 4 C 0 181125 A 736060 I See footnote Common Stock 2014-10-27 4 C 0 192070 A 928130 I See footnote Common Stock 2014-10-27 4 C 0 252052 A 1180182 I See footnote Common Stock 2014-10-27 4 C 0 123846 A 1304028 I See footnote Common Stock 2014-10-27 4 P 0 83170 10.00 A 1387198 I See footnote Series A Convertible Preferred Stock 2014-10-27 4 C 0 5000000 0 D Common Stock 374921 0 I See footnote Series A-1 Convertible Preferred Stock 2014-10-27 4 C 0 2341664 0 D Common Stock 180014 0 I See footnote Series B Convertible Preferred Stock 2014-10-27 4 C 0 2336956 0 D Common Stock 181125 0 I See footnote Series C Convertible Preferred Stock 2014-10-27 4 C 0 2478183 0 D Common Stock 192070 0 I See footnote Series D Convertible Preferred Stock 2014-10-27 4 C 0 4000070 0 D Common Stock 252052 0 I See footnote Common Stock Warrants 2014-10-27 4 D 0 1965454 0 D Common Stock 123846 0 I See footnote The Series A Convertible Preferred Stock automatically converted into the Issuer's Common Stock on a 1-for-1.19 basis (after giving effect to the 1-for-15.87 reverse stock split effected by the Issuer on October 6, 2014) upon the closing of the Issuer's initial public offering without payment of further consideration and has no expiration date. The Series A-1 Convertible Preferred Stock automatically converted into the Issuer's Common Stock on a 1-for-1.22 basis (after giving effect to the 1-for-15.87 reverse stock split effected by the Issuer on October 6, 2014) upon the closing of the Issuer's initial public offering without payment of further consideration and has no expiration date. The Series B Convertible Preferred Stock automatically converted into the Issuer's Common Stock on a 1-for-1.23 basis (after giving effect to the 1-for-15.87 reverse stock split effected by the Issuer on October 6, 2014) upon the closing of the Issuer's initial public offering without payment of further consideration and has no expiration date. The Series C Convertible Preferred Stock automatically converted into the Issuer's Common Stock on a 1-for-1.23 basis (after giving effect to the 1-for-15.87 reverse stock split effected by the Issuer on October 6, 2014) upon the closing of the Issuer's initial public offering without payment of further consideration and has no expiration date. The Series D Convertible Preferred Stock automatically converted into the Issuer's Common Stock on a 1-for-1 basis (after giving effect to the 1-for-15.87 reverse stock split effected by the Issuer on October 6, 2014) upon the closing of the Issuer's initial public offering without payment of further consideration and has no expiration date. The Common Stock Warrants were exercised as a disposition to the Issuer and converted to shares of the Issuer's Common Stock upon the closing of the Issuer's initial public offering without payment of further consideration and has no expiration date. Consists of securities held directly by Prism Venture Partners V, L.P. ("PVP V") and Prism Venture Partners V-A, L.P. ("PVP V-A"). Prism Investment Partners V, L.P. ("PIP V") is the sole general partner of PVP V and PVP V-A. Prism Venture Partners V, LLC ("PVP LLC") is the sole general partner of PIP V. Brendan O'Leary ("O'Leary") is a member of PVP LLC. O'Leary may be deemed to beneficially own the shares held by PVP V and PVP V-A, but O'Leary disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. /s/ Dina Ciarimboli as attorney in fact for Brendan O'Leary 2014-10-29