SEC Form 4/A · accession 0001209191-15-000683
Inogen Inc · INGN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owners
Rebecca B Robertson
10% Owner
Barbara N Lubash
10% Owner
Versant Venture Capital II, LP
10% Owner
Versant Affiliates Fund II-A, LP
10% Owner
Versant Side Fund II, LP
10% Owner
Bradley J Bolzon Ph.D.
10% Owner
Versant Ventures II LLC
10% Owner
Charles M Warden
10% Owner
Period of report
Dec 18, 2014
Accepted (ET)
Jan 5, 2015 · 2:36 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001294133
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2 | Dec 18, 2014 | J | 9,235 | $0.00 | D | 31,334 | I | See Footnote |
| Common StockF4 | Dec 18, 2014 | J | 4,345 | $0.00 | D | 14,764 | I | See Footnote |
| Common StockF6 | Dec 18, 2014 | J | 486,420 | $0.00 | D | 2,041,988 | I | See Footnote |
| Common StockF8 | Dec 18, 2014 | J | 59,218 | $0.00 | A | 59,218 | I | See Footnote |
| Common StockF8 | Dec 18, 2014 | J | 1,126 | $0.00 | A | 60,344 | I | See Footnote |
| Common StockF8 | Dec 18, 2014 | J | 60,344 | $0.00 | D | 0 | I | See Footnote |
| Common StockF11,F12 | Dec 18, 2014 | J | 7,946 | $0.00 | A | 7,946 | I | By Lubash Moses LLC and Evan Michael Moses Trust |
| Common StockF13 | Dec 18, 2014 | J | 3,975 | $0.00 | A | 3,975 | I | By Robertson Family Trust |
| Common StockF14 | Dec 18, 2014 | J | 305 | $0.00 | A | 4,280 | I | By Robertson Family Trust |
| Common StockF15 | Dec 18, 2014 | J | 7,636 | $0.00 | A | 35,446 | D | |
| Common StockF16 | Dec 18, 2014 | J | 2,084 | $0.00 | A | 9,785 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents a pro-rata in-kind distribution of Common Stock of the Issuer for no consideration by Versant Affiliates Fund II-A, L.P. ("VAF II-A") to its partners.
- F10Represents a pro-rata in-kind distribution of Common Stock of the Issuer by VV II without consideration to its members.
- F11The shares are held by Lubash Moses LLC (the "LLC") for the benefit of Barbara N. Lubash. Barbara N. Lubash is a manager of the LLC.
- F12The shares are held by the Evan Michael Moses Trust for the benefit of one or more family member of Barbara Lubash.
- F13The shares are held by the Robertson Family Trust (the "Trust") for the benefit of Rebecca B. Robertson. Rebecca B. Robertson is a trustee of the Trust.
- F14The shares are held by the Robertson Family Trust (the "Trust") for the benefit of Rebecca Robertson. Rebecca Robertson is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of her proportionate pecuniary interest therein.
- F15The shares are held by Bradley J. Bolzon.
- F16The shares are held by Charles M. Warden.
- F2The shares are held by VAF II-A. Versant Ventures II, LLC ("VV II") serves as the sole general partner of VAF II-A. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VV II and share voting and dispositive power over the shares held by VAF II-A, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
- F3Represents a pro-rata in-kind distribution of Common Stock of the Issuer for no consideration by Versant Side Fund II, L.P. ("VSF II") to its partners.
- F4The shares are held by VSF II. VV II serves as the sole general partner of VSF II. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VV II and share voting and dispositive power over the shares held by VSF II, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
- F5Represents a pro-rata in-kind distribution of Common Stock of the Issuer for no consideration by Versant Venture Capital II, L.P. ("VVC II") to its partners.
- F6The shares are held by VVC II. VV II serves as the sole general partner of VVC II. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VV II and share voting and dispositive power over the shares held by VVC II, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
- F7Represents a change in the form of ownership by virtue of the receipt of shares in the pro-rata in-kind distribution of Common Stock of the Issuer by VVC II.
- F8The shares are held by VV II. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VV II and share voting and dispositive power over the shares, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
- F9Represents a change in the form of ownership by virtue of the receipt of shares in the pro-rata in-kind distribution of Common Stock of the Issuer by VAF II-A.
Remarks
Filing 2 of 2