SEC Form 4 · accession 0001104659-15-050339
Conformis Inc · CFMS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Laurent Souviron
Director
Period of report
Jul 7, 2015
Accepted (ET)
Jul 8, 2015 · 7:00 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001305773
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jul 7, 2015 | C | 262,500 | — | A | 262,500 | I | See footnote. |
| Common StockF1,F2 | Jul 7, 2015 | C | 487,500 | — | A | 750,000 | I | See footnote. |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series E-1 Preferred StockF2,F1 | — | Jul 7, 2015 | C | 525,000 | D | — | — | Common Stock | 262,500 | 0 | I |
| Series E-2 Preferred StockF2,F1 | — | Jul 7, 2015 | C | 975,000 | D | — | — | Common Stock | 487,500 | 0 | I |
Explanation of responses
- F1The Series E-1 and E-2 Preferred Stock converted into Common Stock on a two-for-one basis upon the closing of the Issuer's initial public offering without the payment of consideration. The Series E-1 and E-2 Preferred Stock were convertible at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering, and had no expiration date.
- F2The securities are directly held by AGC Equity Partners Special Opportunities Fund I L.P. ("AGC Equity Partners"). The Reporting Person is affiliated with and has a pecuniary interest in AGC Equity Partners and disclaims beneficial ownership of all shares except to the extent of his pecuniary interest therein.
Remarks
Exhibit 24 - Power of Attorney