SEC Form 4 · accession 0001209191-15-003272
Inogen Inc · INGN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
Ross A Jaffe M.D.
10% Owner
Samuel D Colella
10% Owner
Rebecca B Robertson
10% Owner
William J Link Ph.D.
10% Owner
Brian G Atwood
10% Owner
Donald B Milder
10% Owner
Versant Venture Capital II, LP
10% Owner
Versant Affiliates Fund II-A, LP
10% Owner
Versant Side Fund II, LP
10% Owner
Versant Ventures II LLC
10% Owner
Period of report
Jan 6, 2015
Accepted (ET)
Jan 8, 2015 · 9:39 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 StockF3 | Jan 6, 2015 | J | 6,952 | $0.00 | D | 7,812 | I | See Footnote |
| Common StockF5 | Jan 6, 2015 | J | 778,272 | $0.00 | D | 1,263,716 | I | See Footnote |
| Common StockF6 | Jan 6, 2015 | J | 136,039 | $0.00 | A | 136,039 | I | See Footnote |
| Common StockF6 | Jan 7, 2015 | J | 136,039 | $0.00 | D | 0 | I | See Footnote |
| Common StockF8 | Jan 7, 2015 | J | 17,832 | $0.00 | A | 54,163 | I | By Colella Family Partners and Colella Family Trust UTA Dated 9/21/92 |
| Common StockF8 | Jan 6, 2015 | J | 778 | $0.00 | A | 54,941 | I | By Collela Family Partners and Collela Family Trust UTA Dated 9/21/92 |
| Common StockF10 | Jan 7, 2015 | J | 17,832 | $0.00 | A | 56,127 | I | By Atwood Edminster Trust |
| Common StockF10 | Jan 6, 2015 | J | 389 | $0.00 | A | 56,516 | I | By Atwood Edminster Trust |
| Common StockF11 | Jan 7, 2015 | J | 17,832 | $0.00 | A | 56,385 | I | By The Jaffe Family Trust |
| Common StockF11 | Jan 6, 2015 | J | 486 | $0.00 | A | 56,871 | I | By The Jaffe Family Trust |
| Common StockF12 | Jan 7, 2015 | J | 17,832 | $0.00 | A | 56,385 | I | By The Link Family Trust |
| Common StockF12 | Jan 6, 2015 | J | 486 | $0.00 | A | 56,871 | I | By The Link Family Trust |
| Common StockF13 | Jan 7, 2015 | J | 4,459 | $0.00 | A | 16,329 | I | By Milder Community Property Trust |
| Common StockF13 | Jan 6, 2015 | J | 972 | $0.00 | A | 17,301 | I | By Milder Community Property Trust |
| Common StockF1 | holding | — | — | — | 31,334 | I | See Footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The shares are held by Versant Affiliates Fund II-A, L.P. ("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.
- F10The shares are held by the Atwood-Edminster Trust dated 4/2/2000 (the "Trust") for the benefit of Brian G. Atwood. Brian G. Atwood is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
- F11The shares are held by the The Jaffe Family Trust (the "Trust") for the benefit of Ross A. Jaffe. Ross A. Jaffe is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
- F12The shares are held by the The Link Family Trust (the "Trust") for the benefit of William J. Link. William J. Link is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
- F13The shares are held by the Milder Community Property Trust (the "Trust") for the benefit of Donald B. Milder. Donald B. Milder is a trustee of the Trust. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
- F2Represents a pro-rata in-kind distribution of Common Stock of the Issuer by Versant Side Fund II, L.P. ("VSF II") without consideration to its partners.
- F3The 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.
- F4Represents a pro-rata in-kind distribution of Common Stock of the Issuer by Versant Venture Capital II, L.P. ("VVC II") without consideration to its partners.
- F5The 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.
- F6The 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 held by VV II, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
- F7Represents a pro-rata in-kind distribution of Common Stock of the Issuer by VV II without consideration to its members.
- F8The shares are held by Colella Family Partners and Colella Family Trust UTA Dated 9/21/92 for the benefit of Samuel D. Colella. Samuel D. Colella is a general partner of Colella Family Partners and a trustee of Colella Family Trust UTA Dated 9/21/92. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his proportionate pecuniary interest therein.
- F9Represents a pro-rata in-kind distribution of Common Stock of the Issuer by VSF II without consideration to its partners.
Remarks
Filing 1 of 2