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) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series C Convertible Preferred Stock
|
08/16/2005 |
Â
(2)
|
Common Stock
|
396,825
(2)
|
$
0
(2)
|
I
|
Quaker BioVentures, L.P.
(1)
|
Series C Convertible Preferred Stock
|
08/16/2005 |
Â
(2)
|
Common Stock
|
132,275
(2)
|
$
0
(2)
|
D
|
Â
|
Series C Convertible Preferred Stock
|
04/17/2006 |
Â
(2)
|
Common Stock
|
396,825
(2)
|
$
0
(2)
|
I
|
Quaker BioVentures, L.P.
(1)
|
Series C Convertible Preferred Stock
|
04/17/2006 |
Â
(2)
|
Common Stock
|
132,275
(2)
|
$
0
(2)
|
D
|
Â
|
Series D Convertible Preferred Stock
|
09/13/2006 |
Â
(2)
|
Common Stock
|
135,586
(2)
|
$
0
(2)
|
I
|
Quaker BioVentures, L.P.
(1)
|
Series D Convertible Preferred Stock
|
09/13/2006 |
Â
(2)
|
Common Stock
|
45,195
(2)
|
$
0
(2)
|
D
|
Â
|
Series D Convertible Preferred Stock
|
03/09/2007 |
Â
(2)
|
Common Stock
|
135,586
(2)
|
$
0
(2)
|
I
|
Quaker BioVentures, L.P.
(1)
|
Series D Convertible Preferred Stock
|
03/09/2007 |
Â
(2)
|
Common Stock
|
45,195
(2)
|
$
0
(2)
|
D
|
Â
|
* |
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) |
These shares are owned by Quaker BioVentures, L.P., which is under common control with Garden State Life Sciences Venture Fund L.P. Quaker BioVentures Capital, L.P. serves as the general partner of Quaker BioVentures, L.P. and Garden State Life Sciences Venture Fund L.P. and is the indirect beneficial owner of these shares. Quaker Bioventures Capital LLC serves as the general partner of Quaker Bioventure Capital, L.P. and is also the indirect beneficial owner of these shares. Garden State Life Sciences Venture Fund L.P. disclaims beneficial ownership of these shares except to the extent of its proportionate pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of the shares for purposes of section 16 or for any other purpose. |
(2) |
Each share is convertible and will automatically convert on a 1-for-1 basis into the Issuer's common stock upon the closing of the Issuer's initial public offering of common stock pursuant to an effecive registration statement filed with the U.S. Securities and Exchange Commission. These shares have no expiration date. |