0001209191-21-007928.txt : 20210204
0001209191-21-007928.hdr.sgml : 20210204
20210204202520
ACCESSION NUMBER: 0001209191-21-007928
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210204
FILED AS OF DATE: 20210204
DATE AS OF CHANGE: 20210204
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Eclipse GP III, LLC
CENTRAL INDEX KEY: 0001763854
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39976
FILM NUMBER: 21592963
BUSINESS ADDRESS:
STREET 1: 514 HIGH STREET, SUITE 4
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: (415) 692-1720
MAIL ADDRESS:
STREET 1: 514 HIGH STREET, SUITE 4
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Eclipse Ventures Fund I, L.P.
CENTRAL INDEX KEY: 0001641394
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39976
FILM NUMBER: 21592964
BUSINESS ADDRESS:
STREET 1: 501 SECOND STREET SUITE 300
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94107
BUSINESS PHONE: (415) 366-8393
MAIL ADDRESS:
STREET 1: 501 SECOND STREET SUITE 300
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94107
FORMER NAME:
FORMER CONFORMED NAME: Formation8 Partners Hardware Fund I, L.P.
DATE OF NAME CHANGE: 20150505
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Eclipse Fund III, L.P.
CENTRAL INDEX KEY: 0001763853
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39976
FILM NUMBER: 21592965
BUSINESS ADDRESS:
STREET 1: 514 HIGH STREET, SUITE 4
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: (415) 692-1720
MAIL ADDRESS:
STREET 1: 514 HIGH STREET, SUITE 4
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Eclipse Ventures GP I, LLC
CENTRAL INDEX KEY: 0001843678
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39976
FILM NUMBER: 21592966
BUSINESS ADDRESS:
STREET 1: 514 HIGH STREET
STREET 2: SUITE 4
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: 650-720-4667
MAIL ADDRESS:
STREET 1: 514 HIGH STREET
STREET 2: SUITE 4
CITY: PALO ALTO
STATE: CA
ZIP: 94301
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Lucira Health, Inc.
CENTRAL INDEX KEY: 0001652724
STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835]
IRS NUMBER: 272491037
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1412 62ND STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: (814) 574-1546
MAIL ADDRESS:
STREET 1: 1412 62ND STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
FORMER COMPANY:
FORMER CONFORMED NAME: DiAssess Inc.
DATE OF NAME CHANGE: 20150908
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2021-02-04
0
0001652724
Lucira Health, Inc.
LHDX
0001763854
Eclipse GP III, LLC
514 HIGH STREET
SUITE 4
PALO ALTO
CA
94301
0
0
1
0
0001641394
Eclipse Ventures Fund I, L.P.
514 HIGH STREET
SUITE 4
PALO ALTO
CA
94301
0
0
1
0
0001763853
Eclipse Fund III, L.P.
514 HIGH STREET
SUITE 4
PALO ALTO
CA
94301
0
0
1
0
0001843678
Eclipse Ventures GP I, LLC
514 HIGH STREET
SUITE 4
PALO ALTO
CA
94301
0
0
1
0
Series A Preferred Stock
Common Stock
976852
I
See footnote
Series B Preferred Stock
Common Stock
877445
I
See footnote
Series C Preferred Stock
Common Stock
185512
I
See footnote
Series C Preferred Stock
Common Stock
3710257
D
Convertible Promissory Note
13.60
2022-12-11
Common Stock
473729
D
Each share of Series A Preferred Stock, Series B Preferred Stock, and Series C Preferred Stock (the "Preferred Stock") automatically converts on a one-for-one basis into Common Stock upon the closing of the Issuer's initial public offering (the "IPO"), for no additional consideration. The shares of Preferred Stock have no expiration date.
The securities are held directly by Eclipse Ventures Fund I, L.P. ("Eclipse I"). Eclipse Ventures GP I, LLC ("Eclipse I GP") is the general partner of Eclipse I and may be deemed to have voting and dispositive power over the shares held by Eclipse I. Mr. Susan, a member of the Issuer's board of directors, is the sole managing member of Eclipse I GP and may be deemed to have voting and dispositive power over the shares held by Eclipse I. Eclipse I GP and Mr. Susan disclaim beneficial ownership of the shares held by Eclipse I except to the extent of their respective pecuniary interests therein, if any.
The securities are held directly by Eclipse Fund III, L.P. ("Eclipse III"). Eclipse GP III, LLC ("Eclipse III GP") is the general partner of Eclipse III and may be deemed to have voting and dispositive power over the shares held by Eclipse III. Mr. Susan, a member of the Issuer's board of directors, is the sole managing member of Eclipse III GP and may be deemed to have voting and dispositive power over the shares held by Eclipse III. Eclipse III GP and Mr. Susan disclaim beneficial ownership of the shares held by Eclipse III except to the extent of their respective pecuniary interests therein, if any.
The convertible promissory note will automatically convert into shares of the Issuer's Common Stock upon the closing of the IPO.
Eclipse GP III, LLC /s/ Lior Susan, Managing Member
2021-02-04
Eclipse Ventures Fund I, L.P. By: Eclipse Ventures GP I, LLC, its General Partner /s/ Lior Susan, Managing Member
2021-02-04
Eclipse Fund III, L.P., By: Eclipse GP III, LC, its General Partner, /s/ Lior Susan, Managing Member
2021-02-04
Eclipse Ventures GP I, LLC /s/ Lior Susan, Managing Member
2021-02-04