0001209191-14-009032.txt : 20140211 0001209191-14-009032.hdr.sgml : 20140211 20140211143404 ACCESSION NUMBER: 0001209191-14-009032 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140211 FILED AS OF DATE: 20140211 DATE AS OF CHANGE: 20140211 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Revance Therapeutics, Inc. CENTRAL INDEX KEY: 0001479290 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 770551645 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7555 GATEWAY BLVD. CITY: NEWARK STATE: CA ZIP: 94560 BUSINESS PHONE: 510-742-3400 MAIL ADDRESS: STREET 1: 7555 GATEWAY BLVD. CITY: NEWARK STATE: CA ZIP: 94560 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ESSEX WOODLANDS HEALTH VENTURES FUND VIII-B LP CENTRAL INDEX KEY: 0001452935 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36297 FILM NUMBER: 14593438 BUSINESS ADDRESS: STREET 1: 21 WATERWAY AVENUE STREET 2: SUITE 225 CITY: THE WOODLANDS STATE: TX ZIP: 77380 BUSINESS PHONE: 281-364-1555 MAIL ADDRESS: STREET 1: 21 WATERWAY AVENUE STREET 2: SUITE 225 CITY: THE WOODLANDS STATE: TX ZIP: 77380 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ESSEX WOODLANDS HEALTH VENTURES FUND VIII-A LP CENTRAL INDEX KEY: 0001428991 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36297 FILM NUMBER: 14593439 BUSINESS ADDRESS: STREET 1: 435 TASSO STREET STREET 2: SUITE 305 CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: 650-543-1555 MAIL ADDRESS: STREET 1: 435 TASSO STREET STREET 2: SUITE 305 CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ESSEX WOODLANDS HEALTH VENTURES FUND VIII LP CENTRAL INDEX KEY: 0001428992 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36297 FILM NUMBER: 14593440 BUSINESS ADDRESS: STREET 1: 21 WATERWAY AVENUE STREET 2: SUITE 225 CITY: THE WOODLANDS STATE: TX ZIP: 77380 BUSINESS PHONE: 281-528-1958 MAIL ADDRESS: STREET 1: 21 WATERWAY AVENUE STREET 2: SUITE 225 CITY: THE WOODLANDS STATE: TX ZIP: 77380 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2014-02-11 0 0001479290 Revance Therapeutics, Inc. RVNC 0001428992 ESSEX WOODLANDS HEALTH VENTURES FUND VIII LP C/O ESSEX WOODLANDS HEALTH VENTURES 335 BRYANT STREET, THIRD FLOOR PALO ALTO CA 94301 0 0 1 0 0001428991 ESSEX WOODLANDS HEALTH VENTURES FUND VIII-A LP C/O ESSEX WOODLANDS HEALTH VENTURES 335 BRYANT STREET, THIRD FLOOR PALO ALTO CA 94301 0 0 1 0 0001452935 ESSEX WOODLANDS HEALTH VENTURES FUND VIII-B LP C/O ESSEX WOODLANDS HEALTH VENTURES 335 BRYANT STREET, THIRD FLOOR PALO ALTO CA 94301 0 0 1 0 Common Stock 2014-02-11 4 C 0 2781396 A 2781396 I by Essex Woodlands Health Ventures Fund VIII, L.P. Common Stock 2014-02-11 4 C 0 596812 A 3378208 I by Essex Woodlands Health Ventures Fund VIII, L.P. Common Stock 2014-02-11 4 X 0 369124 A 3747332 I by Essex Woodlands Health Ventures Fund VIII, L.P. Common Stock 2014-02-11 4 C 0 200538 A 200538 I by Essex Woodlands Health Ventures Fund VIII-A, L.P. Common Stock 2014-02-11 4 C 0 43029 A 243567 I by Essex Woodlands Health Ventures Fund VIII-A, L.P. Common Stock 2014-02-11 4 X 0 26605 A 270172 I by Essex Woodlands Health Ventures Fund VIII-A, L.P. Common Stock 2014-02-11 4 C 0 87190 A 87190 I by Essex Woodlands Health Ventures Fund VIII-B, L.P. Common Stock 2014-02-11 4 C 0 18708 A 105898 I by Essex Woodlands Health Ventures Fund VIII-B, L.P. Common Stock 2014-02-11 4 X 0 11560 A 117458 I by Essex Woodlands Health Ventures Fund VIII-B, L.P. Series E-3 Convertible Preferred Stock 2014-02-11 4 C 0 575384 D Common Stock 575384 0 I by Essex Woodlands Health Ventures Fund VIII, L.P. Series E-4 Convertible Preferred Stock 2014-02-11 4 C 0 1801888 D Common Stock 1801888 0 I by Essex Woodlands Health Ventures Fund VIII, L.P. Series E-5 Convertible Preferred Stock 2014-02-11 4 C 0 404124 D Common Stock 404124 0 I by Essex Woodlands Health Ventures Fund VIII, L.P. Convertible Promissory Notes 2014-02-11 4 C 0 596812 D Common Stock 596812 0 I by Essex Woodlands Health Ventures Fund VIII, L.P. Warrant to Purchase Common Stock 2014-02-11 4 X 0 369124 D Common Stock 369124 0 I by Essex Woodlands Health Ventures Fund VIII, L.P. Series E-3 Convertible Preferred Stock 2014-02-11 4 C 0 41485 D Common Stock 41485 0 I by Essex Woodlands Health Ventures Fund VIII-A, L.P. Series E-4 Convertible Preferred Stock 2014-02-11 4 C 0 129916 D Common Stock 129916 0 I by Essex Woodlands Health Ventures Fund VIII-A, L.P. Series E-5 Convertible Preferred Stock 2014-02-11 4 C 0 29137 D Common Stock 29137 0 I by Essex Woodlands Health Ventures Fund VIII-A, L.P. Convertible Promissory Notes 2014-02-11 4 C 0 43029 D Common Stock 43029 0 I by Essex Woodlands Health Ventures Fund VIII-A, L.P. Warrant to Purchase Common Stock 2014-02-11 4 X 0 26605 D Common Stock 26605 0 I by Essex Woodlands Health Ventures Fund VIII-A, L.P. Series E-3 Convertible Preferred Stock 2014-02-11 4 C 0 18037 D Common Stock 18037 0 I by Essex Woodlands Health Ventures Fund VIII-B, L.P. Series E-4 Convertible Preferred Stock 2014-02-11 4 C 0 56485 D Common Stock 56485 0 I by Essex Woodlands Health Ventures Fund VIII-B, L.P. Series E-5 Convertible Preferred Stock 2014-02-11 4 C 0 12668 D Common Stock 12668 0 I by Essex Woodlands Health Ventures Fund VIII-B, L.P. Convertible Promissory Notes 2014-02-11 4 C 0 18708 D Common Stock 18708 0 I by Essex Woodlands Health Ventures Fund VIII-B, L.P. Warrant to Purchase Common Stock 2014-02-11 4 X 0 11560 D Common Stock 11560 0 I by Essex Woodlands Health Ventures Fund VIII-B, L.P. Issued upon conversion of Series E-3, E-4 and E-5 Preferred Stock upon closing of the Issuer's initial public offering. Each share of the Issuer's Series E-1, Series E-2, Series E-3, Series E-4 and Series E-5 Preferred Stock automatically converted into 1 share of the Issuer's Common Stock upon the closing of the Issuer's initial public offering and has no expiration date. The voting and dispositive decisions with respect to the shares held by Essex Woodlands Health Ventures Fund VIII, L.P. are made by its general partner, Essex Woodland Health Ventures VIII, LLC and one of Issuer's directors, Ronald W Eastman. Convertible Promissory Notes in the aggregate principal amount of $8,609,375.00 were issued between October 8, 2013 and January 16, 2014 by the Issuer pursuant to a Note and Warrant Purchase Agreement dated October 8, 2013, as amended. The principal amount of $8,609,375.00 plus interest accrued through October 7, 2014, at the rate of 12% per annum converted automatically upon the closing of the Issuer's initial public offering into shares of Common Stock at a conversion price that equals to 100% of the per share price of the Common Stock sold in the Issuer's initial public offering. Issued upon closing of the Issuer's initial public offering pursuant to automatic net exercise of warrants to purchase common stock at an exercise price of $0.15 per share. The voting and dispositive decisions with respect to the shares held by Essex Woodlands Health Ventures Fund VIII-A, L.P. are made by its general partner, Essex Woodland Health Ventures VIII, LLC and one of Issuer's directors, Ronald W Eastman. Convertible Promissory Notes in the aggregate principal amount of $620,738.64 were issued between October 8, 2013 and January 16, 2014 by the Issuer pursuant to a Note and Warrant Purchase Agreement dated October 8, 2013, as amended. The principal amount of $620,738.64 plus interest accrued through October 7, 2014, at the rate of 12% per annum converted automatically upon the closing of the Issuer's initial public offering into shares of Common Stock at a conversion price that equals to 100% of the per share price of the Common Stock sold in the Issuer's initial public offering. The voting and dispositive decisions with respect to the shares held by Essex Woodlands Health Ventures Fund VIII-B, L.P. are made by its general partner, Essex Woodland Health Ventures VIII, LLC and one of Issuer's directors, Ronald W Eastman. Convertible Promissory Notes in the aggregate principal amount of $269,886.36 were issued between October 8, 2013 and January 16, 2014 by the Issuer pursuant to a Note and Warrant Purchase Agreement dated October 8, 2013, as amended. The principal amount of $269,886.36 plus interest accrued through October 7, 2014, at the rate of 12% per annum converted automatically upon the closing of the Issuer's initial public offering into shares of Common Stock at a conversion price that equals to 100% of the per share price of the Common Stock sold in the Issuer's initial public offering. Automatically net exercised into shares of the Issuer's Common Stock at an exercise price of $0.15 per share. Includes certain warrants to purchase capital stock of the Issuer issued between October 8, 2013 and January 16, 2014 by the Issuer pursuant to a Note and Warrant Purchase Agreement dated October 8, 2013, as amended. The warrant shares were automatically net exercised into Common Stock of the Issuer upon the closing of the Issuer's initial public offering at a per share exercise price of $0.15 per share on a post-split basis. /s/ Gordon Ho, Attorney-in-fact 2014-02-11