SEC FORM
3
SEC Form 3
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/09/2013
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3. Issuer Name and Ticker or Trading Symbol
MACROGENICS INC
[ MGNX ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series A-1 Convertible Preferred Stock |
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Common Stock |
12,001,000 |
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I |
See Footnote
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Series B Convertible Preferred Stock |
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Common Stock |
10,131,856 |
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I |
See Footnote
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Series C Convertible Preferred Stock |
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Common Stock |
5,547,611 |
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I |
See Footnote
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Series D-2 Convertible Preferred Stock |
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Common Stock |
613,402 |
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I |
See Footnote
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Series D-2 Convertible Preferred Stock Warrants |
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Common Stock |
46,005 |
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I |
See Footnote
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
|
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
|
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
|
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
|
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
|
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
|
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
|
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
|
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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Explanation of Responses: |
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/s/ W. Stephen Holmes, Managing Director |
10/09/2013 |
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/s/ W. Stephen Holmes, Managing Director |
10/09/2013 |
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/s/ W. Stephen Holmes, Managing Director |
10/09/2013 |
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/s/ W. Stephen Holmes, Managing Director |
10/09/2013 |
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/s/ Harvey B. Cash by Karen A. Wilson Power of Attorney |
10/09/2013 |
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/s/ Philip T. Gianos by Karen A. Wilson Power of Attorney |
10/09/2013 |
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/s/ Gilbert H. Kliman by Karen A. Wilson Power of Attorney |
10/09/2013 |
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/s/ W. Scott Hedrick by Karen A. Wilson Power of Attorney |
10/09/2013 |
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/s/ W. Stephen Holmes By Karen A. Wilson Power of Attorney |
10/09/2013 |
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** Signature of Reporting Person |
Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* If the form is filed by more than one reporting person,
see
Instruction
5
(b)(v). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
Exhibit 24.1
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS:
The undersigned, Harvey B. Cash, hereby constitutes and appoints Karen A. Wilson
as his true and lawful Attorney-in-Fact, with full power in his name and on his
behalf, to take all actions and do all things necessary with respect to all
matters arising in connection with the ownership reporting requirements of the
securities laws of the United States, including the execution and delivery of
all documents in connection therewith.
The undersigned agrees to indemnify said Attorney-in-Fact against, and hold her
free and harmless from, and all loss, cost, expense, damage or liability which
she may incur or sustain as a result of any action taken by her in good faith
pursuant to this Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked in
writing by the undersigned and the authority granted herein may be relied upon
by any person until such person has actually received written notice of
revocation.
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney this
12th day of February, 1996.
HARVEY B. CASH
/s/ Harvey B. Cash
----------------------------------------
Exhibit 24.2
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS:
The undersigned, Philip T. Gianos, hereby constitutes and appoints Karen A.
Wilson as his true and lawful Attorney-in-Fact, with full power in his name and
on his behalf, to take all actions and do all things necessary with respect to
all matters arising in connection with the ownership reporting requirements of
the securities laws of the United States, including the execution and delivery
of all documents in connection therewith.
The undersigned agrees to indemnify said Attorney-in-Fact against, and hold her
free and harmless from, and all loss, cost, expense, damage or liability which
she may incur or sustain as a result of any action taken by her in good faith
pursuant to this Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked in
writing by the undersigned and the authority granted herein may be relied upon
by any person until such person has actually received written notice of
revocation.
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney this
28th day of May, 1996.
PHILIP T. GIANOS
/s/ Philip T. Gianos
---------------------------------------
Exhibit 24.3
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS:
The undersigned, Gilbert H. Kliman, hereby constitutes and appoints Karen A.
Wilson as his true and lawful Attorney-in-Fact, with full power in his name and
on his behalf, to take all actions and do all things necessary with respect to
all matters arising in connection with the ownership reporting requirements of
the securities laws of the United States, including the execution and delivery
of all documents in connection therewith.
The undersigned agrees to indemnify said Attorney-in-Fact against, and hold her
free and harmless from, and all loss, cost, expense, damage or liability which
she may incur or sustain as a result of any action taken by her in good faith
pursuant to this Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked in
writing by the undersigned and the authority granted herein may be relied upon
by any person until such person has actually received written notice of
revocation.
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney this 8th
day of September, 2000.
GILBERT H. KLIMAN
/s/ Gilbert H. Kliman
----------------------------------------
Exhibit 24.4
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS:
The undersigned, W. Scott Hedrick, hereby constitutes and appoints Karen A.
Wilson as his true and lawful Attorney-in-Fact, with full power in his name and
on his behalf, to take all actions and do all things necessary with respect to
all matters arising in connection with the ownership reporting requirements of
the securities laws of the United States, including the execution and delivery
of all documents in connection therewith.
The undersigned agrees to indemnify said Attorney-in-Fact against, and hold her
free and harmless from, and all loss, cost, expense, damage or liability which
she may incur or sustain as a result of any action taken by her in good faith
pursuant to this Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked in
writing by the undersigned and the authority granted herein may be relied upon
by any person until such person has actually received written notice of
revocation.
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney this
28th day of May, 1996.
W. SCOTT HEDRICK
/s/ W. Scott Hedrick
----------------------------------------
Exhibit 24.5
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS:
The undersigned, W. Stephen Holmes, hereby constitutes and appoints Karen A.
Wilson as his true and lawful Attorney-in-Fact, with full power in his name and
on his behalf, to take all actions and do all things necessary with respect to
all matters arising in connection with the ownership reporting requirements of
the securities laws of the United States, including the execution and delivery
of all documents in connection therewith.
The undersigned agrees to indemnify said Attorney-in-Fact against, and hold her
free and harmless from, and all loss, cost, expense, damage or liability which
she may incur or sustain as a result of any action taken by her in good faith
pursuant to this Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked in
writing by the undersigned and the authority granted herein may be relied upon
by any person until such person has actually received written notice of
revocation.
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney this
28th day of May, 1996.
W. STEPHEN HOLMES
/s/ W. Stephen Holmes
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Exhibit 99
Exhibit 99
FORM 3 JOINT FILER INFORMATION
Name of
"Reporting Persons": InterWest Partners VIII, L.P. ("IW8")
InterWest Investors VIII, L.P. ("II8")
InterWest Investors QVIII, L.P. ("IIQ8")
InterWest Management Partners VIII, LLC ("IMP8")
Harvey B. Cash
Philip T. Gianos
W. Scott Hedrick
W. Stephen Holmes
Gilbert H. Kliman
Address: 2710 Sand Hill Road, Suite 200
Menlo Park, CA 94025
Designated Filer: InterWest Partners VIII, L.P.
Issuer and Ticker Symbol: MacroGenics, Inc. ("MGNX")
Date of Event: October 9, 2013
Each of the following is a Joint Filer with InterWest Partners VIII L.P. ("IW8") and
may be deemed to share indirect beneficial ownership in the securities set forth on
the attached Form 3:
InterWest Management Partners VIII, LLC ("IMP8") is the general partner of IW8, II8,
and IIQ8 and has sole voting and investment control over the shares owned by IW8, II8
and IIQ8. Harvey B. Cash, Philip T. Gianos, W. Scott Hedrick, W. Stephen Holmes,
Gilbert H. Kliman, and Arnold L. Oronsky are Managing Directors of IMP8. Arnold L.
Oronsky, a Managing Director of IMP8 is also a Director of the Issuer, and has filed
a separate Form 3 in his own name.
All Reporting Persons disclaim beneficial ownership of shares of MacroGenics, Inc.
stock held by IW8, II8, and IIQ8, except to the extent of their respective pecuniary
interest therein. The filing of this statement shall not be deemed an admission that,
for purposes of Section 16 of the Securities Exchange Act of 1934, or otherwise, any
of the Reporting Persons are the beneficial owner of all of the equity securities
covered by this statement.
Each of the Reporting Persons listed above has designated InterWest Partners VIII,
L.P. as its designated filer of Forms 3, 4 and 5 in accordance with Section 16(a) of
the Securities Exchange Act of 1934 and the rules thereunder. Each Reporting Person
has appointed InterWest Management Partners VIII, LLC as its attorney in fact for the
purpose of making reports relating to transaction in MacroGenics, Inc. Common Stock.
INTERWEST PARTNERS VIII, L.P.
By: InterWest Management Partners VIII, LLC
Its General Partner
/s/ W. Stephen Holmes
By: --------------------------------------
W. Stephen Holmes, Managing Director
INTERWEST INVESTORS VIII, L.P.
By: InterWest Management Partners VIII, LLC
Its General Partner
/s/ W. Stephen Holmes
By: --------------------------------------
W. Stephen Holmes, Managing Director
INTERWEST INVESTORS Q VIII, L.P.
By: InterWest Management Partners VIII, LLC
Its General Partner
/s/ W. Stephen Holmes
By: ---------------------------------------
W. Stephen Holmes, Managing Director
INTERWEST MANAGEMENT PARTNERS VIII, LLC
/s/ W. Stephen Holmes
By: ------------------------------------
W. Stephen Holmes, Managing Director
Harvey B. Cash, an individual W. Stephen Holmes, an individual
By: InterWest Management Partners VIII, LLC, By: InterWest Management Partners VIII, LLC,
as Attorney-in-Fact as Attorney-in-Fact
/s/ Harvey B. Cash by Karen A. Wilson /s/ W. Stephen Holmes by Karen A. Wilson
By: --------------------------------------- By:-----------------------------------------
Karen A. Wilson, Power of Attorney Karen A. Wilson, Power of Attorney
Philip T. Gianos, an individual Gilbert H. Kliman, an individual
By: InterWest Management Partners VIII, LLC, By: InterWest Management Partners VIII, LLC,
as Attorney-in-Fact as Attorney-in-Fact
/s/ Philip T. Gianos by Karen A. Wilson /s/ Gilbert H. Kilman by Karen A. Wilson
By: ---------------------------------------- By: -----------------------------------------
Karen A. Wilson, Power of Attorney Karen A. Wilson, Power of Attorney
W. Scott Hedrick, an individual
By: InterWest Management Partners VIII, LLC,
as Attorney-in-Fact
/s/ W. Scott Hedrick by Karen A. Wilson
By: ----------------------------------------
Karen A. Wilson, Power of Attorney