SEC Form 4 · accession 0000904454-17-000469
Clovis Oncology, Inc. · CLVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James C Blair
Director
Period of report
Jun 23, 2017
Accepted (ET)
Jun 27, 2017 · 4:24 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001466301
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jun 23, 2017 | J | 286,857 | — | D | 1,000,000 | I | By Domain Partners VII, L.P. |
| Common StockF1,F2 | Jun 23, 2017 | J | 2,869 | — | A | 92,518 | I | By One Palmer Square Associates VII, LLC |
| Common StockF2 | holding | — | — | — | 35,506 | I | By DP VII Associates, L.P. | |
| Common StockF2 | holding | — | — | — | 32,760 | I | By Domain Associates, LLC | |
| Common Stock | holding | — | — | — | 2,185 | D | ||
| Common StockF3 | holding | — | — | — | 2,927 | I | By Susan W. and James C. Blair Family L.P. |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Distribution of shares in kind by Domain Partners VII, L.P. to its partners, including 2,869 shares to One Palmer Square Associates VII, LLC, the sole general partner of Domain Partners VII, L.P.
- F2The Reporting Person is a managing member of One Palmer Square Associates VII, LLC, the sole general partner of Domain Partners VII, L.P. and DP VII Associates, L.P., and of Domain Associates, VII, LLC. Pursuant to Instruction 4(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities owned by each such entity, however he disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him.
- F3The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.