-----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, EpHuyMSVAdeBI5nOB+i1toHDJqQJGRBFP33ntVYASCdj6C0H95xNiUTu/DL+fWj5 oEadC/v6HtWMPfprWyfjsg== 0000904454-10-000483.txt : 20101201 0000904454-10-000483.hdr.sgml : 20101201 20101201101420 ACCESSION NUMBER: 0000904454-10-000483 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101129 FILED AS OF DATE: 20101201 DATE AS OF CHANGE: 20101201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BLAIR JAMES C CENTRAL INDEX KEY: 0001024000 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34962 FILM NUMBER: 101223759 MAIL ADDRESS: STREET 1: 5880 PACIFIC CENTER BLVD CITY: SAN DIEGO STATE: CA ZIP: 92121-4204 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ZOGENIX, INC. CENTRAL INDEX KEY: 0001375151 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 205300780 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 12671 HIGH BLUFF DRIVE STREET 2: SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92130 BUSINESS PHONE: (858) 259-1165 MAIL ADDRESS: STREET 1: 12671 HIGH BLUFF DRIVE STREET 2: SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92130 FORMER COMPANY: FORMER CONFORMED NAME: ZOGENIX INC DATE OF NAME CHANGE: 20060911 4 1 edgar.xml PRIMARY DOCUMENT X0303 4 2010-11-29 0001375151 ZOGENIX, INC. ZGNX 0001024000 BLAIR JAMES C C/O DOMAIN ASSOCIATES, LLC ONE PALMER SQUARE PRINCETON NJ 08542 1 0 1 0 Common Stock 2010-11-29 4 C 0 2064781 A 2064781 I By Domain Partners VII, L.P. Common Stock 2010-11-29 4 C 0 1232861 A 3297642 I By Domain Partners VII, L.P. Common Stock 2010-11-29 4 C 0 873800 A 4171442 I By Domain Partners VII, L.P. Common Stock 2010-11-29 4 P 0 2310589 4.00 A 6482031 I By Domain Partners VII, L.P. Common Stock 2010-11-29 4 C 0 35215 A 35215 I By DP VII Associates, L.P. Common Stock 2010-11-29 4 C 0 21027 A 56242 I By DP VII Associates, L.P. Common Stock 2010-11-29 4 C 0 14903 A 71145 I By DP VII Associates, L.P. Common Stock 2010-11-29 4 P 0 39410 4.00 A 110555 I By DP VII Associates, L.P. Common Stock 2010-11-29 4 C 0 9894 A 9894 I By Domain Partners VI, L.P. Common Stock 2010-11-29 4 C 0 106 A 106 I By DP VI Associates, L.P. Series A-1 Preferred Stock 2010-11-29 4 C 0 2064781 0 D Common Stock 2064781 0 I By Domain Partners VII, L.P. Series B Preferred Stock 2010-11-29 4 C 0 1232861 0 D Common Stock 1232861 0 I By Domain Partners VII, L.P. Convertible Promissory Notes 2010-11-29 4 C 0 873800 0 D Common Stock 873800 0 I By Domain Partners VII, L.P. Series A-1 Preferred Stock 2010-11-29 4 C 0 35215 0 D Common Stock 35215 0 I By DP VII Associates, L.P. Series B Preferred Stock 2010-11-29 4 C 0 21027 0 D Common Stock 21027 0 I By DP VII Associates, L.P. Convertible Promissory Notes 2010-11-29 4 C 0 14903 0 D Common Stock 14903 0 I By DP VII Associates, L.P. Series A-1 Preferred Stock 2010-11-29 4 C 0 9894 0 D Common Stock 9894 0 I By Domain Partners VI, L.P. Series A-1 Preferred Stock 2010-11-29 4 C 0 106 0 D Common Stock 106 0 I By DP VI Associates, L.P. All outstanding shares of the Issuer's preferred stock were automatically converted into Common Stock upon the closing of the Issuer's initial public offering (the "IPO"), for no additional consideration. All Convertible Promissory Notes, plus interest accrued thereon through the closing of the IPO, automatically converted into Common Stock upon the closing of the IPO, based on the IPO price of $4.00 per share. The Reporting Person also indirectly beneficially owns 11,000 shares of Common Stock held by Domain Associates, LLC. The Reporting Person is a Managing Member of (i) One Palmer Square Associates VII, LLC, which is the sole general partner of Domain Partners VII, L.P. and DP VII Associates, L.P., (ii) One Palmer Square Associates VI, LLC, which is the sole general partner of Domain Partners VI, L.P. and DP VI Associates, L.P., and (iii) Domain Associates, LLC. Pursuant to Instruction (4)(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his or her pecuniary interest therein and/or that are not actually distributed to him or her. /s/Kathleen K. Schoemaker, Attorney-in-Fact 2010-12-01 -----END PRIVACY-ENHANCED MESSAGE-----