-----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, PXIWew3vPR1VTmphjo4gDFSrxWzS2aJaDlrKbtphu/Ium5/VWq1D5BxinoBkO798 RYlWA6+I2qK7kkGVrycdIw== 0000929624-97-000142.txt : 19970222 0000929624-97-000142.hdr.sgml : 19970222 ACCESSION NUMBER: 0000929624-97-000142 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970214 SROS: NASD GROUP MEMBERS: BERNARD LACROUTE GROUP MEMBERS: BROOK H. BYERS GROUP MEMBERS: E. FLOYD KVAMME GROUP MEMBERS: JAMES P. LALLY GROUP MEMBERS: JOSEPH S. LACOB GROUP MEMBERS: KLEINER PERKINS CAUFIELD & BYERS VI LP GROUP MEMBERS: KPCB VI ASSOCIATES, LP GROUP MEMBERS: L. JOHN DOERR GROUP MEMBERS: VINOD KHOSLA SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HEARTPORT INC CENTRAL INDEX KEY: 0001009871 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 943222307 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-50069 FILM NUMBER: 97534357 BUSINESS ADDRESS: STREET 1: 200 CHESAPEAKE DR CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 4153067900 MAIL ADDRESS: STREET 1: 200 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: KLEINER PERKINS CAUFIELD & BYERS VI LP CENTRAL INDEX KEY: 0000936312 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] IRS NUMBER: 943517816 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 4152332750 MAIL ADDRESS: STREET 1: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 SC 13G 1 SCHEDULE 13G --------------------------- OMB APPROVAL --------------------------- OMB number: 3235-0145 Expires: December 31, 1997 Estimated average burden hours per response... 14.90 --------------------------- SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. )* HEARTPORT, INC. _________________________________________________________________ (Name of Issuer) COMMON STOCK _________________________________________________________________ (Title of Class of Securities) 004219 69 1 _________________________________________________________________ (CUSIP Number) Check the following box if a fee is being paid with this statement. . (A fee is not required if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7). *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). (Continued on following pages) Page 1 of 17 Pages Exhibit Index Contained on Page 14 - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 2 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Kleiner Perkins Caufield & Byers VI, L.P., a California Limited Partnership ("KPCB VI") 94-3157816 - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 California Limited Partnership - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF - 0 - SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 2,730,000 OWNED BY ----------------------------------------------------------- EACH SOLE DISPOSITIVE POWER 7 REPORTING - 0 - PERSON ----------------------------------------------------------- SHARED DISPOSITIVE POWER WITH 8 2,730,000 - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,730,000 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.2% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 PN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 2 of 17 pages - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 3 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON KPCB VI Associates, L.P., a California Limited Partnership ("KPCB VI Associates") 94-3158010 - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 California Limited Partnership - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF - 0 - SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 2,730,000 shares directly held by KPCB OWNED BY VI. KPCB VI Associates is the general partner of KPCB VI. EACH REPORTING ----------------------------------------------------------- SOLE DISPOSITIVE POWER PERSON 7 -0- WITH ----------------------------------------------------------- SHARED DISPOSITIVE POWER 8 2,730,000 shares directly held by KPCB VI. KPCB VI Associates is the general partner of KPCB VI. - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,730,000 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.2% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 PN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 3 of 17 pages * SEE INSTRUCTIONS BEFORE FILLING OUT! - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 4 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Brook H. Byers - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 38,547 SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 2,730,000 shares directly held by KPCB VI. KPCB VI OWNED BY Associates is the general partner of KPCB VI, and Mr. Byers is a general partner of KPCB VI Associates. Mr. EACH Byers disclaims beneficial ownership of these shares. In addition, the Brook H. Byers Trust holds 7,759 REPORTING shares, beneficial ownership of which Mr. Byers disclaims. PERSON WITH ----------------------------------------------------------- SOLE DISPOSITIVE POWER 7 38,547 ----------------------------------------------------------- SHARED DISPOSITIVE POWER 8 2,730,000 shares directly held by KPCB VI. KPCB VI Associates is the general partner of KPCB VI, and Mr. Byers is a general partner of KPCB VI Associates. Mr. Byers disclaims beneficial ownership of these shares. In addition, the Brook H. Byers Trust holds 7,759 shares, beneficial ownership of which Mr. Byers disclaims. - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,776,306 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.4% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 4 of 17 pages - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 5 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Vinod Khosla - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 19,233 SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 2,730,000 shares directly held by KPCB VI and 13,539 OWNED BY shares held by the Vinod & Neeru Khosla Trust. KPCB VI Associates is the general partner of KPCB VI, and Mr. EACH Khosla is a general partner of KPCB VI Associates. Mr. Khosla disclaims beneficial ownership of these shares. REPORTING ----------------------------------------------------------- PERSON SOLE DISPOSITIVE POWER 7 WITH 19,233 ----------------------------------------------------------- SHARED DISPOSITIVE POWER 8 2,730,000 shares directly held by KPCB VI and 13,539 shares held by the Vinod & Neeru Khosla Trust. KPCB VI Associates is the general partner of KPCB VI, and Mr. Khosla is a general partner of KPCB VI Associates. Mr. Khosla disclaims beneficial ownership of these shares. - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,762,620 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.3% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 5 of 17 pages - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 6 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON E. Floyd Kvamme - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 21,291 SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 2,730,000 shares directly held by KPCB VI. KPCB VI OWNED BY Associates is the general partner of KPCB VI, and Mr. Kvamme is a general partner of KPCB VI Associates. Mr. EACH Kvamme disclaims beneficial ownership of these shares. REPORTING ----------------------------------------------------------- PERSON SOLE DISPOSITIVE POWER 7 WITH 21,291 ----------------------------------------------------------- SHARED DISPOSITIVE POWER 8 2,730,000 shares directly held by KPCB VI. KPCB VI Associates is the general partner of KPCB VI, and Mr. Kvamme is a general partner of KPCB VI Associates. Mr. Kvamme disclaims beneficial ownership of these shares. - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,751,291 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.3% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 6 of 17 pages - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 7 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON L. John Doerr - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 35,102 SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 2,730,000 shares directly held by KPCB VI, 6,177 OWNED BY shares held directly by L.J. Doerr & A. Doerr, Trustees, Vallejo Trust and 7,759 shares held directly EACH by the Child(ren) of L. John Doerr Trust. KPCB VI Associates is the general partner of KPCB VI, and Mr. REPORTING Doerr is a general partner of KPCB VI Associates. Mr. Doerr disclaims beneficial ownership of these shares. PERSON WITH ----------------------------------------------------------- SOLE DISPOSITIVE POWER 7 35,102 ----------------------------------------------------------- SHARED DISPOSITIVE POWER 8 2,730,000 shares directly held by KPCB VI, 6,177 shares held directly by L.J. Doerr & A. Doerr, Trustees, Vallejo Trust and 7,759 shares held directly by the Child(ren) of L. John Doerr Trust. KPCB VI Associates is the general partner of KPCB VI, and Mr. Doerr is a general partner of KPCB VI Associates. Mr. Doerr disclaims beneficial ownership of these shares. - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,779,038 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.4% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 7 of 17 pages - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 8 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Joseph S. Lacob - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 63,115 (including options exercisable within 60 days for 29,332 shares) SHARES ----------------------------------------------------------- BENEFICIALLY SHARED VOTING POWER 6 OWNED BY 2,730,000 shares directly held by KPCB VI. KPCB VI Associates is the general partner of KPCB VI, and Mr. EACH Lacob is a general partner of KPCB VI Associates. Mr. Lacob disclaims beneficial ownership of these shares. REPORTING PERSON ----------------------------------------------------------- SOLE DISPOSITIVE POWER WITH 7 63,115 (including options exercisable within 60 days for 29,332 shares) ----------------------------------------------------------- SHARED DISPOSITIVE POWER 8 2,730,000 shares directly held by KPCB VI. KPCB VI Associates is the general partner of KPCB VI, and Mr. Lacob is a general partner of KPCB VI Associates. Mr. Lacob disclaims beneficial ownership of these shares. - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,793,115 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.4% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 8 of 17 pages - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 9 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Bernard Lacroute - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 31,310 SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 2,730,000 shares directly held by KPCB VI. KPCB VI OWNED BY Associates is the general partner of KPCB VI, and Mr. Lacroute is a general partner of KPCB VI Associates. EACH Mr. Lacroute disclaims beneficial ownership of these shares. REPORTING ----------------------------------------------------------- PERSON SOLE DISPOSITIVE POWER 7 WITH 31,310 ----------------------------------------------------------- SHARED DISPOSITIVE POWER 8 2,730,000 shares directly held by KPCB VI. KPCB VI Associates is the general partner of KPCB VI, and Mr. Lacroute is a general partner of KPCB VI Associates. Mr. Lacroute disclaims beneficial ownership of these shares. - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,761,310 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.3% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 9 of 17 pages - ----------------------- --------------------- CUSIP NO. 004219 69 1 13G PAGE 10 OF 17 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON James P. Lally - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [X] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 41,598 SHARES ----------------------------------------------------------- BENEFICIALLY SHARED VOTING POWER 6 OWNED BY 2,730,000 shares directly held by KPCB VI. KPCB VI EACH Associates is the general partner of KPCB VI, and Mr. Lally is a general partner of KPCB VI Associates. Mr. REPORTING Lally disclaims beneficial ownership of these shares. PERSON ----------------------------------------------------------- SOLE DISPOSITIVE POWER WITH 7 41,598 ----------------------------------------------------------- SHARED DISPOSITIVE POWER 8 2,730,000 shares directly held by KPCB VI. KPCB VI Associates is the general partner of KPCB VI, and Mr. Lally is a general partner of KPCB VI Associates. Mr. Lally disclaims beneficial ownership of these shares. - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 2,771,598 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 11.4% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 10 of 17 pages Page 11 of 17 Fee enclosed [_] or Amendment No. 3 ITEM 1(A). NAME OF ISSUER. -------------- Heartport, Inc. ITEM 1(B). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES. ----------------------------------------------- 200 Chesapeake Drive Redwood City, California 94063 ITEM 2(A)-(C). NAME, ADDRESS AND CITIZENSHIP OF PERSONS FILING. ----------------------------------------------- This statement is being filed by KPCB VI Associates, L.P., a California Limited Partnership ("KPCB VI Associates"), whose principal business address is 2750 Sand Hill Road, Menlo Park, California 94025. The names, business addresses and citizenships of all the general partners of KPCB VI Associates, are set forth on Exhibit B hereto. KPCB VI Associates is general partner to Kleiner Perkins Caufield & Byers VI, L.P., a California limited partnership ("KPCB VI"). With respect to KPCB VI Associates, this statement relates only to KPCB VI Associates' indirect, beneficial ownership of shares of Common Stock of Heartport, Inc. held directly by KPCB VI (the "Shares") and, with respect to the individual general partners of KPCB VI Associates, to the shares over which they exercise sole voting and dispositive control or which are held by trusts. Management of the business affairs of KPCB VI Associates, including decisions respecting disposition and/or voting of the Shares, is by majority decision of the general partners of KPCB VI Associates listed on Exhibit B hereto, each general partner of whom disclaims beneficial ownership of the Shares. ITEM 2(D) AND (E). TITLE OF CLASS OF SECURITIES AND CUSIP NUMBER. --------------------------------------------- Common Stock CUSIP # 004219 69 1 ITEM 3. Not Applicable. -------------- ITEM 4. OWNERSHIP. --------- See Rows 5-11 of cover pages. ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS. -------------------------------------------- Not applicable. Page 11 of 17 pages Page 12 of 17 ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. --------------------------------------------------------------- Under certain circumstances set forth in the limited partnership agreements of KPCB VI and KPCB VI Associates, the general and limited partners of such entities may have the right to receive dividends from, or the proceeds of the sale of the Shares of Heartport, Inc. owned by each such entity. No such partner's rights relate to more than five percent of the class. ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE ---------------------------------------------------------------------- SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY. -------------------------------------------------------- Not applicable. ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP. --------------------------------------------------------- Not applicable. ITEM 9. NOTICE OF DISSOLUTION OF GROUP. ------------------------------ Not applicable. ITEM 10. CERTIFICATION. ------------- Not applicable. Page 12 of 17 pages Page 13 of 17 SIGNATURES ---------- After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Dated: February 13, 1997 KPCB VI ASSOCIATES, L.P., A CALIFORNIA LIMITED PARTNERSHIP By: ________________________________ A General Partner BROOK H. BYERS VINOD KHOSLA E. FLOYD KVAMME L. JOHN DOERR JOSEPH S. LACOB BERNARD LACROUTE JAMES P. LALLY By: ________________________________ Michael S. Curry Attorney-in-Fact KLEINER PERKINS CAUFIELD & BYERS VI, L.P., A CALIFORNIA LIMITED PARTNERSHIP By KPCB VI Associates, L.P., a California limited partnership, its General Partner By: ________________________________ A General Partner Page 13 of 17 pages Page 14 of 17 EXHIBIT INDEX ------------- Found on Sequentially Exhibit Numbered Page - ------- ------------- Exhibit A: Agreement of Joint Filing 15 Exhibit B: List of General Partners of KPCB VI Associates 16 Page 14 of 17 pages Page 15 of 17 EXHIBIT A --------- Agreement of Joint Filing ------------------------- The undersigned hereby agree that they are filing jointly pursuant to Rule 13d-1 of the Act the statement dated February 13, 1997, containing the information required by Schedule 13G, for the 2,730,000 Shares of Common Stock of Heartport, Inc. held by Kleiner Perkins Caufield & Byers VI, L.P., a California limited partnership, and such other holdings as are reported thereon. Date: February 13, 1997 KPCB VI ASSOCIATES, L.P., A CALIFORNIA LIMITED PARTNERSHIP By: ________________________________ A General Partner BROOK H. BYERS VINOD KHOSLA E. FLOYD KVAMME L. JOHN DOERR JOSEPH LACOB BERNARD LACROUTE JAMES P. LALLY By: ________________________________ A General Partner KLEINER PERKINS CAUFIELD & BYERS VI, L.P., A CALIFORNIA LIMITED PARTNERSHIP By KPCB VI Associates, L.P., a California limited partnership, its General Partner By: ________________________________ A General Partner Page 15 of 17 pages Page 16 of 17 EXHIBIT B --------- General Partners of KPCB VI Associates, a California limited partnership ---------------------------------------------------- Set forth below, with respect to each general partner of KPCB VI Associates, is the following: (a) name; (b) business address and (c) citizenship. 1. (a) Brook H. Byers (b) c/o Kleiner Perkins Caufield & Byers 2750 Sand Hill Road Menlo Park, CA 94025 (c) United States Citizen 2. (a) Vinod Khosla (b) c/o Kleiner Perkins Caufield & Byers 2750 Sand Hill Road Menlo Park, CA 94025 (c) United States Citizen 3. (a) E. Floyd Kvamme (b) c/o Kleiner Perkins Caufield & Byers 2750 Sand Hill Road Menlo Park, CA 94025 (c) United States Citizen 4. (a) L. John Doerr (b) c/o Kleiner Perkins Caufield & Byers 2750 Sand Hill Road Menlo Park, CA 94025 (c) United States Citizen 5. (a) Joseph Lacob (b) c/o Kleiner Perkins Caufield & Byers 2750 Sand Hill Road Menlo Park, CA 94025 (c) United States Citizen
Page 16 of 17 pages Page 17 of 17 6. (a) Bernard Lacroute (b) c/o Kleiner Perkins Caufield & Byers 2750 Sand Hill Road Menlo Park, CA 94025 (c) United States Citizen 7. (a) James P. Lally (b) c/o Kleiner Perkins Caufield & Byers 2750 Sand Hill Road Menlo Park, CA 94025 (c) United States Citizen
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