0001235802-17-000021.txt : 20170127
0001235802-17-000021.hdr.sgml : 20170127
20170127162006
ACCESSION NUMBER: 0001235802-17-000021
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161213
FILED AS OF DATE: 20170127
DATE AS OF CHANGE: 20170127
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HISTOGENICS CORP
CENTRAL INDEX KEY: 0001372299
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 830 WINTER STREET
CITY: WALTHAM
STATE: MA
ZIP: 02451
BUSINESS PHONE: 781-457-7900
MAIL ADDRESS:
STREET 1: 830 WINTER STREET
CITY: WALTHAM
STATE: MA
ZIP: 02451
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SPLIT ROCK PARTNERS II MANAGEMENT, LLC
CENTRAL INDEX KEY: 0001626028
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36751
FILM NUMBER: 17553969
BUSINESS ADDRESS:
STREET 1: 10400 VIKING DRIVE
STREET 2: SUITE 250
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
BUSINESS PHONE: 952-995-7474
MAIL ADDRESS:
STREET 1: 10400 VIKING DRIVE
STREET 2: SUITE 250
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SPLIT ROCK PARTNERS II, LP
CENTRAL INDEX KEY: 0001435895
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36751
FILM NUMBER: 17553970
BUSINESS ADDRESS:
STREET 1: 10400 VIKING DRIVE
STREET 2: SUITE 250
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
BUSINESS PHONE: 952-995-7474
MAIL ADDRESS:
STREET 1: 10400 VIKING DRIVE
STREET 2: SUITE 250
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
FORMER NAME:
FORMER CONFORMED NAME: SPLIT ROCK PARTNERS II LP
DATE OF NAME CHANGE: 20080522
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2016-12-13
0
0001372299
HISTOGENICS CORP
HSGX
0001435895
SPLIT ROCK PARTNERS II, LP
10400 VIKING DRIVE
SUITE 250
EDEN PRAIRIE
MN
55344
0
0
1
0
0001626028
SPLIT ROCK PARTNERS II MANAGEMENT, LLC
10400 VIKING DRIVE
SUITE 250
EDEN PRAIRIE
MN
55344
0
0
1
0
Common Stock
2016-12-13
4
C
0
1114043
A
2775538
D
Series A Convertible Preferred Stock
2016-12-13
4
C
0
2506.5968
0
D
Common Stock
1114043
0
D
All outstanding shares of the Issuer's Series A Convertible Preferred Stock converted on a 1:444.4444444 basis into shares of the Issuer's Common Stock. These shares have no expiration date.
The securities are owned directly by SRP II. Voting and investment power over the securities is delegated to Split Rock Partners II Management, LLC ("SRPM II"), the general partner of SRP II. SRPM II has delegated voting and investment decisions to three individuals who require a two-thirds vote to act. SRPM II disclaims beneficial ownership of the securities except to the extent of any pecuniary interest therein.
/s/ Stacy M. Campbell-Kraft, Authorized Representative
2017-01-27
/s/ Stacy M. Campbell-Kraft, Authorized Representative
2017-01-27