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