SEC Form 4 · accession 0001209191-15-003273
Inogen Inc · INGN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
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
Jan 6, 2015
Accepted (ET)
Jan 8, 2015 · 9:40 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,F9 | Jan 7, 2015 | J | 17,834 | $0.00 | A | 17,834 | I | By Lubash Moses LLC and Evan Michael Moses Trust |
| Common StockF10 | Jan 7, 2015 | J | 8,916 | $0.00 | A | 13,196 | I | By Robertson Family Trust |
| Common StockF11 | Jan 6, 2015 | J | 486 | $0.00 | A | 13,682 | I | By Robertson Family Trust |
| Common StockF12 | Jan 7, 2015 | J | 17,539 | $0.00 | A | 52,985 | D | |
| Common StockF13 | Jan 7, 2015 | J | 4,682 | $0.00 | A | 4,682 | D | |
| 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 Robertson Family Trust (the "Trust") for the benefit of Rebecca B. Robertson. Rebecca B. Robertson is a trustee of the Trust.
- F11The 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.
- F12The shares are held by Bradley J. Bolzon.
- F13The shares are held by Charles M. Warden.
- F2Represents 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.
- 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 for no consideration by Versant Venture Capital II, L.P. ("VVC II") 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, 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 Lubash Moses LLC (the "LLC") for the benefit of Barbara N. Lubash. Barbara N. Lubash is a manager of the LLC.
- F9The shares are held by the Evan Michael Moses Trust for the benefit of one or more family member of Barbara Lubash.
Remarks
Filing 2 of 2