SEC Form 4 · accession 0000904454-16-001500
Vyome Holdings, Inc · HIND
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
Jesse I Treu
10% Owner
James C Blair
10% Owner
Nicole Vitullo
10% Owner
Brian H Dovey
10% Owner
Brian K Halak
10% Owner
Parters Vii L P Domain
10% Owner
Period of report
Oct 12, 2016
Accepted (ET)
Oct 14, 2016 · 11:58 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001427570
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF3,F1,F2 | Oct 12, 2016 | C | 3,985,970 | — | A | 3,985,970 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Preferred StockF1,F2,F3 | — | Oct 12, 2016 | C | 649,835 | D | — | — | Common Stock | 862,879 | 0 | D |
| Series B Preferred StockF1,F2,F3 | — | Oct 12, 2016 | C | 1,206,836 | D | — | — | Common Stock | 1,206,836 | 0 | D |
| Series C Preferred StockF1,F2,F3 | — | Oct 12, 2016 | C | 836,722 | D | — | — | Common Stock | 836,722 | 0 | D |
| Series D Preferred StockF1,F2,F3 | — | Oct 12, 2016 | C | 597,207 | D | — | — | Common Stock | 597,207 | 0 | D |
| Series E Preferred StockF1,F2,F3 | — | Oct 12, 2016 | C | 482,326 | D | — | — | Common Stock | 482,326 | 0 | D |
Explanation of responses
- F1The securities reported as directly beneficially owned by the designated Reporting Person may be deemed to be indirectly beneficially owned by each of the Reporting Owners listed below, each of whom is a managing member of One Palmer Square Associates VII, LLC, the sole general partner of the designated Reporting Person. Pursuant to Instruction 4(b)(iv) of Form 4, each such individual has elected to report as indirectly beneficially owned the entire number of securities owned by the designated Reporting Person, however each of them disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his or her pecuniary interest therein and/or that are not actually distributed to him or her.
- F2As managing members of the sole general partner of DP VII Associates, L.P., each Reporting Owner listed below may also be deemed to indirectly beneficially own the securities of the Issuer held by DP VII Associates, L.P., as reported on a Form 4 for DP VII Associates, L.P. filed on the same date as this Form 4.
- F3All outstanding shares of the Issuer's preferred stock automatically converted into Common Stock upon the closing of the Issuer's initial public offering for no additional consideration. The preferred stock had no expiration date.