SEC FORM
4
SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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2. Issuer Name and Ticker or Trading Symbol
MACROGENICS INC
[ MGNX ]
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5. 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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3. Date of Earliest Transaction
(Month/Day/Year) 10/16/2013
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4. 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 Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
10/16/2013 |
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C |
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962,819 |
A |
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962,819 |
I |
See Footnote
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Common Stock |
10/16/2013 |
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C |
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615,284 |
A |
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1,578,103 |
I |
See Footnote
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Common Stock |
10/16/2013 |
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C |
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295,494 |
A |
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1,873,597 |
I |
See Footnote
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Common Stock |
10/16/2013 |
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C |
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32,671 |
A |
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1,906,268 |
I |
See Footnote
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Common Stock |
10/16/2013 |
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C |
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2,448 |
A |
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1,908,716 |
I |
See Footnote
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series A-1 Convertible Preferred Stock |
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10/16/2013 |
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C |
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12,001,000 |
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Common Stock |
962,819 |
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0 |
I |
See Footnote
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Series B Convertible Preferred Stock |
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10/16/2013 |
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C |
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10,131,856 |
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Common Stock |
615,284 |
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0 |
I |
See Footnote
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Series C Convertible Preferred Stock |
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10/16/2013 |
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C |
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5,547,611 |
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Common Stock |
295,494 |
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0 |
I |
See Footnote
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Series D-2 Convertible Preferred Stock |
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10/16/2013 |
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C |
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613,402 |
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Common Stock |
32,671 |
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0 |
I |
See Footnote
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Series D-2 Convertible Preferred Stock Warrant to buy |
$12.2425
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10/16/2013 |
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X |
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46,005 |
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10/16/2013 |
Series D-2 Convertible Preferred Stock |
2,448 |
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0 |
I |
See Footnote
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Series D-2 Convertible Preferred Stock |
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10/16/2013 |
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C |
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2,448 |
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Common Stock |
2,448 |
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0 |
I |
See Footnote
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
2710 SAND HILL RD |
SUITE 200 |
(Street)
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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 |
10/18/2013 |
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/s/ W. Stephen Holmes, Managing Director |
10/18/2013 |
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/s/ W. Stephen Holmes, Managing Director |
10/18/2013 |
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/s/ W. Stephen Holmes, Managing Director |
10/18/2013 |
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/s/ Harvey B. Cash by Karen A. Wilson Power of Attorney |
10/18/2013 |
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/s/ Philip T. Gianos by Karen A. Wilson Power of Attorney |
10/18/2013 |
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/s/ Gilbert H. Kliman by Karen A. Wilson Power of Attorney |
10/18/2013 |
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/s/ W. Scott Hedrick by Karen A. Wilson Power of Attorney |
10/18/2013 |
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/s/ W. Stephen Holmes By Karen A. Wilson Power of Attorney |
10/18/2013 |
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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
4
(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 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 16, 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 4:
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 4 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/ Karen A. Wilson /s/ 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/ Karen A. Wilson /s/ 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/ Karen A. Wilson
By: --------------------------------------
Karen A. Wilson, Power of Attorney