SEC Form 4 · accession 0001562180-15-000405
TriVascular Technologies, Inc. · TRIV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Douglas A Roeder
Director · 10% Owner
Period of report
May 22, 2015
Accepted (ET)
May 27, 2015 · 6:12 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001432732
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Options (right to buy)F2,F1 | $5.85 | May 22, 2015 | A | 10,000 | A | — | May 21, 2025 | Common Stock | 10,000 | 10,000 | D |
Explanation of responses
- F11/12th of the shares underlying the option vest and become exercisable in equal monthly installments through May 22, 2016.
- F2Pursuant to the Delphi Management Partners, VII, L.L.C. ("DMP VII") and Delphi Management Partners VIII, L.L.C. ("DMP VIII") LLC Agreements, the Reporting Person is deemed to hold the options for the benefit of DMP VII and DMP VIII, respectively, which are entitled to hold the shares upon issuance. DMP VII and DMP VIII may be deemed the indirect beneficial owners of such shares, and the Reporting Person is a managing member of DMP VII and DMP VIII and may be deemed to share voting and dispositive power over shares held by DMP VII and DMP VIII, respectively. The Reporting Person disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein.