FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Cerulean Pharma Inc. [ CERU ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 04/15/2014 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 04/15/2014 | C | 7,106 | A | (1) | 7,106 | D(2) | |||
Common Stock | 04/15/2014 | C | 2,576 | A | (3) | 9,682 | D(2) | |||
Common Stock | 04/15/2014 | C | 5,868 | A | (4) | 15,550 | D(2) | |||
Common Stock | 04/15/2014 | C | 8,199 | A | (5) | 23,749 | D(2) | |||
Common Stock | 04/15/2014 | C | 7,589 | A | (6) | 31,338 | D(2) | |||
Common Stock | 04/15/2014 | C | 4,954 | A | (7) | 36,292 | D(2) | |||
Common Stock | 04/15/2014 | C | 5,146 | A | (8) | 41,438 | D(2) | |||
Common Stock | 04/15/2014 | P | 18,869 | A | $7 | 60,307 | I | By Trust(9) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series A Convertible Preferred Stock | (1) | 04/15/2014 | C | 76,923 | (1) | (1) | Common Stock | 7,106 | $0.00 | 0 | D(2) | ||||
Series B Convertible Preferred Stock | (3) | 04/15/2014 | C | 22,801 | (3) | (3) | Common Stock | 2,576 | $0.00 | 0 | D(2) | ||||
Series B-1 Convertible Preferred Stock | (4) | 04/15/2014 | C | 31,500 | (4) | (4) | Common Stock | 5,868 | $0.00 | 0 | D(2) | ||||
Series C Convertible Preferred Stock | (5) | 04/15/2014 | C | 118,954 | (5) | (5) | Common Stock | 8,199 | $0.00 | 0 | D(2) | ||||
Series D Convertible Preferred Stock | (6) | 04/15/2014 | C | 110,107 | (6) | (6) | Common Stock | 7,589 | $0.00 | 0 | D(2) | ||||
7% Convertible Promissory Notes | $7 | 04/15/2014 | C | $34,679.18 | (7) | (7) | Common Stock | 4,954(7) | $0.00 | 0 | D(2) | ||||
7% Convertible Promissory Notes | $5.43 | 04/15/2014 | C | $27,917.59 | (8) | (8) | Common Stock | 5,146(8) | $0.00 | 0 | D(2) | ||||
Warrant to purchase Series C | $0.74(10) | 04/15/2014 | J | 5,522 | (10) | 11/12/2017 | Series C Convertible Preferred Stock | 5,522 | $0.00 | 0 | D(2) | ||||
Warrant to purchase Series C | $10.74(10) | 04/15/2014 | J | 380 | (10) | 11/12/2017 | Common Stock | 380 | $0.00 | 380 | D(2) |
Explanation of Responses: |
1. In connection with the completion of the Company's initial public offering, each share of Series A Convertible Preferred Stock converted automatically into Common Stock on a 0.0924-for-1 basis into the number of shares of Common Stock listed in Table I, column 5 and Table II, column 7 without payment of further consideration. The Series A Convertible Preferred Stock had no expiration date. |
2. William H. Rastetter holds the securities jointly with his wife as community property. |
3. In connection with the completion of the Company's initial public offering, each share of Series B Convertible Preferred Stock converted automatically into Common Stock on a 0.1130-for-1 basis into the number of shares of Common Stock listed in Table I, column 5 and Table II, column 7 without payment of further consideration. The Series B Convertible Preferred Stock had no expiration date. |
4. In connection with the completion of the Company's initial public offering, each share of Series B-1 Convertible Preferred Stock converted automatically into Common Stock on a 0.1863-for-1 basis into the number of shares of Common Stock listed in Table I, column 5 and Table II, column 7 without payment of further consideration. The Series B-1 Convertible Preferred Stock had no expiration date. |
5. In connection with the completion of the Company's initial public offering, each share of Series C Convertible Preferred Stock converted automatically into Common Stock on a 0.0689-for-1 basis into the number of shares of Common Stock listed in Table I, column 5 and Table II, column 7 without payment of further consideration. The Series C Convertible Preferred Stock had no expiration date. |
6. In connection with the completion of the Company's initial public offering, each share of Series D Convertible Preferred Stock converted automatically into Common Stock on a 0.0689-for-1 basis into the number of shares of Common Stock listed in Table I, column 5 and Table II, column 7 without payment of further consideration. The Series D Convertible Preferred Stock had no expiration date. |
7. Represents the number of shares of Common Stock issued upon conversion of all principal and accrued interest on the 7% Convertible Promissory Notes issued on August 13, 2013 through April 15, 2014, at a conversion price of $7.00 per share of Common Stock, which was the initial public offering price. The Notes had no expiration date and were exercisable any time after August 15, 2014 at the holder's election or automatically upon a qualified financing. |
8. Represents the number of shares of Common Stock issuable upon conversion of all principal and accrued interest on the 7% Convertible Promissory issued on February 14, 2014 Notes through April 15, 2014, at a conversion price equal to $5.43 per share of Common Stock, which was equal to 77.5% of the Company's initial public offering price. The Notes had no expiration date and were exercisable any time after February 26, 2015 at the holder's election or automatically upon a qualified financing. |
9. Represents the shares of Common Stock owned of record by The Rastetter Family Trust UAD September 2, 2010 (the "2010 Family Trust") and beneficially by Mr. Rastetter. Mr. Rastetter is a co-trustee of the 2010 Family Trust and has voting and dispositive control over any securities owned of record or beneficially by the 2010 Family Trust. Therefore, Mr. Rastetter may be deemed to beneficially own the shares of Common Stock held by the 2010 Family Trust. |
10. In connection with the completion of the Company's initial public offering of Common Stock, this warrant to purchase shares of Series C Convertible Preferred Stock automatically converted on a 0.0689-for-1 basis into a warrant to purchase shares of Common Stock. Disposition of Warrants to Purchase Series C Convertible Preferred Stock and acquisition of Warrants to Purchase Common Stock are listed solely for the purpose of reporting such conversion of the shares underlying the security. The warrants are exercisable at any time at the holder's election. |
Remarks: |
/s/ Karen L. Roberts as attorney-in-fact for William H. Rastetter | 04/17/2014 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |