0001144204-16-106008.txt : 20160531 0001144204-16-106008.hdr.sgml : 20160531 20160531184923 ACCESSION NUMBER: 0001144204-16-106008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160526 FILED AS OF DATE: 20160531 DATE AS OF CHANGE: 20160531 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TRUPANION INC. CENTRAL INDEX KEY: 0001371285 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 907 NW BALLARD WAY CITY: SEATTLE STATE: WA ZIP: 98107 BUSINESS PHONE: 888-738-7478 MAIL ADDRESS: STREET 1: 907 NW BALLARD WAY CITY: SEATTLE STATE: WA ZIP: 98107 FORMER COMPANY: FORMER CONFORMED NAME: VETINSURANCE INTERNATIONAL INC DATE OF NAME CHANGE: 20060802 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Maveron LLC CENTRAL INDEX KEY: 0001587953 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36537 FILM NUMBER: 161687441 BUSINESS ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 BUSINESS PHONE: (206)288-1700 MAIL ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MEP Associates III, L.P. CENTRAL INDEX KEY: 0001587647 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36537 FILM NUMBER: 161687442 BUSINESS ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 BUSINESS PHONE: (206)288-1700 MAIL ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Maveron III Entrepreneurs Fund, L.P. CENTRAL INDEX KEY: 0001587646 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36537 FILM NUMBER: 161687443 BUSINESS ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 BUSINESS PHONE: (206)288-1700 MAIL ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Maveron Equity Partners III, L.P. CENTRAL INDEX KEY: 0001587648 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36537 FILM NUMBER: 161687444 BUSINESS ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 BUSINESS PHONE: (206)288-1700 MAIL ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Maveron General Partner III LLC CENTRAL INDEX KEY: 0001587645 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36537 FILM NUMBER: 161687445 BUSINESS ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 BUSINESS PHONE: (206)288-1700 MAIL ADDRESS: STREET 1: 411 1ST AVENUE SOUTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98104 4 1 v441390_4.xml OWNERSHIP DOCUMENT X0306 4 2016-05-26 1 0001371285 TRUPANION INC. TRUP 0001587645 Maveron General Partner III LLC 411 1ST AVENUE SOUTH, SUITE 600 SEATTLE WA 98104 0 0 1 0 0001587648 Maveron Equity Partners III, L.P. 411 1ST AVENUE SOUTH, SUITE 600 SEATTLE WA 98104 0 0 1 0 0001587646 Maveron III Entrepreneurs Fund, L.P. 411 1ST AVENUE SOUTH, SUITE 600 SEATTLE WA 98104 0 0 1 0 0001587647 MEP Associates III, L.P. 411 1ST AVENUE SOUTH, SUITE 600 SEATTLE WA 98104 0 0 1 0 0001587953 Maveron LLC 411 1ST AVENUE SOUTH, SUITE 600 SEATTLE WA 98104 0 0 1 0 Common Stock 2016-05-26 4 J 0 847787 0 D 4708259 I see footnote Common Stock 2016-05-26 4 J 0 8478 0 A 8478 D Common Stock 2016-05-26 4 J 0 116243 0 D 645566 I see footnote Common Stock 2016-05-26 4 J 0 35970 0 D 199761 I see footnote Common Stock 2016-05-26 4 J 0 359 0 A 8837 D Common Stock 2016-05-26 4 J 0 8837 0 D 0 D Common Stock 2016-05-26 4 J 0 1033 0 A 1033 I see footnote Maveron Equity Partners III, L.P. ("Maveron Equity") made pro rata distributions for no consideration of 847,787 shares of common stock of the issuer to its partners on May 26, 2016. Shares are owned directly by Maveron Equity. Maveron General Partner III LLC ("Maveron GP"), which is the general partner of Maveron Equity, has sole voting and investment power over the securities held by Maveron Equity. Maveron GP disclaims beneficial ownership over such securities except to the extent of its pecuniary interest therein. In addition, Dan Levitan, who is a Director of the issuer, and certain other individuals are managing members of Maveron GP and may be deemed to share voting and investment power over the shares held of record by Maveron Equity. Each of such individuals disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. Shares acquired by Maveron GP in connection with the distribution of such shares to the partners of Maveron Equity. MEP Associates III, L.P. ("Maveron Associates") made pro rata distributions for no consideration of 116,243 shares of common stock of the issuer to its partners on May 26, 2016. Shares are owned directly by Maveron Associates. Maveron GP, which is the general partner of Maveron Associates, has sole voting and investment power over the securities held by Maveron Associates. Maveron GP disclaims beneficial ownership over such securities except to the extent of its pecuniary interest therein. In addition, Dan Levitan, who is a Director of the issuer, and certain other individuals are managing members of Maveron GP and may be deemed to share voting and investment power over the shares held of record by Maveron Associates. Each of such individuals disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. Maveron III Entrepreneurs Fund, L.P. ("Maveron Entrepreneurs") made pro rata distributions for no consideration of 35,970 shares of common stock of the issuer to its partners on May 26, 2016. Shares are owned directly by Maveron Entrepreneurs. Maveron GP, which is the general partner of Maveron Entrepreneurs, has sole voting and investment power over the securities held by Maveron Entrepreneurs. Maveron GP disclaims beneficial ownership over such securities except to the extent of its pecuniary interest therein. In addition, Dan Levitan, who is a Director of the issuer, and certain other individuals are managing members of Maveron GP and may be deemed to share voting and investment power over the shares held of record by Maveron Entrepreneurs. Each of such individuals disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. Shares acquired by Maveron GP in connection with the distribution of such shares to the partners of Maveron Entrepreneurs. Maveron GP made pro rata distributions for no consideration of 8,837 shares of common stock of the issuer to its members on May 26, 2016. Shares acquired by Maveron LLC in connection with the distribution of such shares to the partners of Maveron Equity and Maveron Entrepreneurs. Shares are owned directly by Maveron LLC. Maveron LLC disclaims beneficial ownership over such securities except to the extent of its pecuniary interest therein. In addition, Dan Levitan, who is a Director of the issuer, and certain other individuals are managing members of Maveron LLC and may be deemed to share voting and investment power over the shares held of record by Maveron LLC. Each of such individuals disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. Each reporting person disclaims the existence of a "group" and disclaims beneficial ownership of any securities except to the extent of such reporting persons' pecuniary interest in such securities. /s/ Pete McCormick, as managing member of Maveron General Partner III, LLC 2016-05-31 /s/ Pete McCormick, as managing member of the GP of Maveron Equity Partners III, L.P. 2016-05-31 /s/ Pete McCormick, as managing member of the GP of Maveron III Entrepreneurs Fund LP 2016-05-31 /s/ Pete McCormick, as managing member of the GP of MEP Associates III, L.P. 2016-05-31 /s/ Pete McCormick, as Attorney-in-Fact for Maveron LLC 2016-05-31