0001181431-14-005334.txt : 20140205
0001181431-14-005334.hdr.sgml : 20140205
20140205191730
ACCESSION NUMBER: 0001181431-14-005334
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140205
FILED AS OF DATE: 20140205
DATE AS OF CHANGE: 20140205
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Eleven Biotherapeutics, Inc.
CENTRAL INDEX KEY: 0001485003
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 252025616
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 215 FIRST STREET
STREET 2: SUITE 400
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-871-9911
MAIL ADDRESS:
STREET 1: 215 FIRST STREET
STREET 2: SUITE 400
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KANIA EDWIN M JR
CENTRAL INDEX KEY: 0001255927
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36296
FILM NUMBER: 14577611
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: AFEYAN NOUBAR
CENTRAL INDEX KEY: 0001222012
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36296
FILM NUMBER: 14577612
MAIL ADDRESS:
STREET 1: 1 SUNSET RIDGE
CITY: LEXINGTON
STATE: MA
ZIP: 02173
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Fund IV General Partner LLC
CENTRAL INDEX KEY: 0001508051
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36296
FILM NUMBER: 14577613
BUSINESS ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures 2007 General Partner LLC
CENTRAL INDEX KEY: 0001508053
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36296
FILM NUMBER: 14577614
BUSINESS ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Fund IV, L.P.
CENTRAL INDEX KEY: 0001503559
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36296
FILM NUMBER: 14577616
BUSINESS ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Fund 2007, L.P.
CENTRAL INDEX KEY: 0001508052
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36296
FILM NUMBER: 14577617
BUSINESS ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Fund IV-Rx, L.P.
CENTRAL INDEX KEY: 0001590973
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36296
FILM NUMBER: 14577615
BUSINESS ADDRESS:
STREET 1: ONE MEMORIAL DRIVE
STREET 2: 7TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: C/O ELEVEN BIOTHERAPEUTICS
STREET 2: 215 FIRST STREET, SUITE 400
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
3
1
rrd401014.xml
FORM 3
X0206
3
2014-02-05
0
0001485003
Eleven Biotherapeutics, Inc.
EBIO
0001508052
Flagship Ventures Fund 2007, L.P.
1 MEMORIAL DRIVE, 7TH FLOOR
CAMBRIDGE
MA
02142
0
0
1
0
0001503559
Flagship Ventures Fund IV, L.P.
1 MEMORIAL DRIVE
CAMBRIDGE
MA
02142
0
0
1
0
0001590973
Flagship Ventures Fund IV-Rx, L.P.
1 MEMORIAL DRIVE, 7TH FLOOR
CAMBRIDGE
MA
02142
0
0
1
0
0001508053
Flagship Ventures 2007 General Partner LLC
1 MEMORIAL DRIVE, 7TH FLOOR
CAMBRIDGE
MA
02142
0
0
1
0
0001508051
Flagship Ventures Fund IV General Partner LLC
1 MEMORIAL DRIVE, 7TH FLOOR
CAMBRIDGE
MA
02142
0
0
1
0
0001222012
AFEYAN NOUBAR
C/O ELEVEN BIOTHERAPEUTICS, INC.
215 FIRST STREET, SUITE 400
CAMBRIDGE
MA
02142
1
0
0
0
0001255927
KANIA EDWIN M JR
1 MEMORIAL DRIVE, 7TH FLOOR
CAMBRIDGE
MA
02142
0
0
1
0
Common Stock
275590
D
Common Stock
115410
D
Common Stock
28852
D
Series A Convertible Preferred Stock
Common Stock
1417323
D
Series A Convertible Preferred Stock
Common Stock
661417
D
Series A Convertible Preferred Stock
Common Stock
165354
D
Series B Convertible Preferred Stock
Common Stock
264600
D
Series B Convertible Preferred Stock
Common Stock
66150
D
Held by Flagship Ventures Fund 2007, L.P. ("Flagship 2007"). Flagship Ventures 2007 General Partner LLC ("Flagship 2007 LLC") is the general partner of Flagship 2007. Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Flagship 2007 LLC. Flagship 2007 LLC and each of these individuals may be deemed to share voting and investment power with respect to all shares held by Flagship 2007. Each of the filing persons disclaims beneficial ownership of the shares except to the extent of his or its pecuniary interest therein. Mr. Afeyan is a member of the Issuer's board of directors and is filing a separate Form 3 concurrently herewith.
Held by Flagship Ventures Fund IV, L.P. ("Flagship IV"). Flagship Ventures Fund IV General Partner LLC ("Flagship IV LLC") is the general partner of Flagship IV. Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Flagship IV LLC. Flagship IV LLC and each of these individuals may be deemed to share voting and investment power with respect to all shares held by Flagship IV. Each of the filing persons disclaims beneficial ownership of the shares except to the extent of his or its pecuniary interest therein. Mr. Afeyan is a member of the Issuer's board of directors and is filing a separate Form 3 concurrently herewith.
Held by Flagship Ventures Fund IV-Rx, L.P. ("Flagship IV-Rx"). Flagship Ventures Fund IV General Partner LLC ("Flagship IV LLC") is the general partner of Flagship IV Rx. Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Flagship IV LLC. Flagship IV LLC and each of these individuals may be deemed to share voting and investment power with respect to all shares held by Flagship IV-Rx. Each of the filing persons disclaims beneficial ownership of the shares except to the extent of his or its pecuniary interest therein. Mr. Afeyan is a member of the Issuer's board of directors and is filing a separate Form 3 concurrently herewith.
Convertible into Common Stock on a 1-for-6.35 basis without payment of further consideration. Each share will automatically convert into 1/6.35 of a share of Common Stock upon the closing of the Issuer's initial public offering.
Not applicable.
FLAGSHIP VENTURES FUND 2007, L.P., By: Flagship Ventures 2007 General Partner LLC, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2014-02-05
FLAGSHIP VENTURES 2007 GENERAL PARTNER LLC, L.P., By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2014-02-05
FLAGSHIP VENTURES FUND IV, L.P., By: Flagship Ventures Fund IV General Partner LLC, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2014-02-05
FLAGSHIP VENTURES FUND IV GENERAL PARTNER LLC, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2014-02-05
FLAGSHIP VENTURES FUND IV-RX, L.P., By: Flagship Ventures Fund IV General Partner LLC, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2014-02-05
/s/ Noubar B. Afeyan, Ph.D., NOUBAR B. AFEYAN, PH.D.
2014-02-05
/s/ Edwin M. Kania, Jr., EDWIN M. KANIA, JR.
2014-02-05