Edgar Filing: Clovis Oncology, Inc.

Ownership Submission

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

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(Print or Type Responses)

1. Name and Address of Reporting Person ^*

Â Versant Venture Capital IV, L.P.

2. Date of Event Requiring Statement (Month/Day/Year)
11/15/2011

3. Issuer Name and Ticker or Trading Symbol
Clovis Oncology, Inc. [CLVS]

(Last)

(First)

(Middle)

3000 SAND HILL ROAD,Â BUILDING FOUR, SUITE 210

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

_____ Director	__X__ 10% Owner
_____ Officer (give title below)	_____ Other (specify below)

5. If Amendment, Date Original Filed(Month/Day/Year)

(Street)

MENLO PARK,Â CAÂ 94025

6. Individual or Joint/Group Filing(Check Applicable Line)
___ Form filed by One Reporting Person
_X_ Form filed by More than One Reporting Person

(City)

(State)

(Zip)

Table I - Non-Derivative Securities Beneficially Owned

1.Title of Security
(Instr. 4)

2. Amount of Securities Beneficially Owned
(Instr. 4)

3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)

4. Nature of Indirect Beneficial Ownership
(Instr. 5)

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.			SEC 1473 (7-02)
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security		6. Nature of Indirect Beneficial Ownership (Instr. 5)
Series A-1 Convertible Preferred Stock ⁽¹⁾	Â ⁽²⁾	Â ⁽³⁾	Common Stock	295,404	$ 0	I	See Footnote ⁽⁴⁾
Series A-1 Convertible Preferred Stock ⁽¹⁾	Â ⁽²⁾	Â ⁽³⁾	Common Stock	1,861	$ 0	I	See Footnote ⁽⁵⁾
Series A-2 Convertible Preferred Stock ⁽¹⁾	Â ⁽²⁾	Â ⁽³⁾	Common Stock	295,404	$ 0	I	See Footnote ⁽⁴⁾
Series A-2 Convertible Preferred Stock ⁽¹⁾	Â ⁽²⁾	Â ⁽³⁾	Common Stock	1,861	$ 0	I	See Footnote ⁽⁵⁾
Series B Convertible Preferred Stock ⁽¹⁾	Â ⁽²⁾	Â ⁽³⁾	Common Stock	639,403	$ 0	I	See Footnote ⁽⁴⁾
Series B Convertible Preferred Stock ⁽¹⁾	Â ⁽²⁾	Â ⁽³⁾	Common Stock	4,027	$ 0	I	See Footnote ⁽⁵⁾
Convertible Promissory Note ⁽⁶⁾	Â ⁽²⁾	Â ⁽³⁾	Common Stock	267,755 ⁽⁶⁾	$ 3,396,603.32	I	See Footnote ⁽⁴⁾
Convertible Promissory Note ⁽⁶⁾	Â ⁽²⁾	Â ⁽³⁾	Common Stock	1,686 ⁽⁶⁾	$ 21,396.68	I	See Footnote ⁽⁵⁾

Reporting Owners

Reporting Owner Name / Address	Relationships
Reporting Owner Name / Address	Director	10% Owner	Officer	Other
Versant Venture Capital IV, L.P. 3000 SAND HILL ROAD BUILDING FOUR, SUITE 210 MENLO PARK,Â CAÂ 94025	Â	Â X	Â	Â
Versant Side Fund IV, L.P. 3000 SAND HILL ROAD BUILDING FOUR, SUITE 210 MENLO PARK,Â CAÂ 94025	Â	Â X	Â	Â
Versant Ventures IV, LLC 3000 SAND HILL ROAD BUILDING FOUR, SUITE 210 MENLO PARK,Â CAÂ 94025	Â	Â X	Â	Â

Signatures

VERSANT VENTURE CAPITAL IV, L.P. By: Versant Ventures IV, LLC Its: General Partner By: /s/ Brian G. Atwood Brian G. Atwood, Managing Director		11/15/2011
^**Signature of Reporting Person		Date
VERSANT SIDE FUND IV, L.P. By: Versant Ventures IV, LLC Its: General Partner By: /s/ Brian G. Atwood Brian G. Atwood, Managing Director		11/15/2011
^**Signature of Reporting Person		Date
VERSANT VENTURES IV, LLC By: /s/ Brian G. Atwood Brian G. Atwood, Managing Director		11/15/2011
^**Signature of Reporting Person		Date

Explanation of Responses:

*	If the form is filed by more than one reporting person, see Instruction 5(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).
(1)	Each share of Common Stock, Series A-1, Series A-2 and Series B Convertible Preferred Stock will automatically convert on a 1-for-1 basis into common stock upon the consummation of the Issuer's initial public offering.
(2)	The securities are immediately convertible.
(3)	The expiration date is not relevant to the conversion of these securities.
(4)	The shares are held by Versant Venture Capital IV, L.P. ("Versant IV"). In their capacity as managing members of Versant Ventures IV, LLC which is the general partner of each Versant IV, Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen share voting and investment authority over the shares held by the Versant IV and may be deemed to beneficially own the shares. Each of Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen disclaim beneficial ownership of these shares except to the extent of his or her pecuniary interest therein.
(5)	The shares are held by Versant Side Fund IV, L.P. ("Versant Side"). In their capacity as managing members of Versant Ventures IV, LLC which is the general partner of each Versant Side, Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen share voting and investment authority over the shares held by the Versant Side and may be deemed to beneficially own the shares. Each of Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen disclaim beneficial ownership of these shares except to the extent of his or her pecuniary interest therein.
(6)	The outstanding principal amount and all accrued and unpaid interest thereon will convert into shares of common stock at a price per share equal to the initial public offering price upon consummation of the Issuer's initial public offering.

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