Filing Details

Accession Number:
0000904454-11-000617
Form Type:
4
Zero Holdings:
No
Publication Time:
2011-11-21 20:23:31
Reporting Period:
2011-11-21
Filing Date:
2011-11-21
Filing Date Changed:
2011-11-21
Accepted Time:
2011-11-21 20:23:31
Original Submission Date:
Issuer
Cik Name Symbol Sector (SIC) IRS No
1466301 Clovis Oncology, Inc. CLVS Pharmaceutical Preparations (2834) 900475355
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1024000 C James Blair C/o Domain Associates, Llc
One Palmer Square
Princeton NJ 08542
Yes No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings
Common Stock Acquisiton 2011-11-21 409,192 $0.00 409,192
Common Stock Acquisiton 2011-11-21 409,192 $0.00 818,384
Common Stock Acquisiton 2011-11-21 885,696 $0.00 1,704,080
Common Stock Acquisiton 2011-11-21 370,799 $0.00 2,074,879
Common Stock Acquisiton 2011-11-21 916,058 $13.00 2,990,937
Common Stock Acquisiton 2011-11-21 6,979 $0.00 6,979
Common Stock Acquisiton 2011-11-21 6,979 $0.00 13,958
Common Stock Acquisiton 2011-11-21 15,106 $0.00 29,064
Common Stock Acquisiton 2011-11-21 6,324 $0.00 35,388
Common Stock Acquisiton 2011-11-21 15,625 $13.00 51,013
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect By Domain Partners VII, L.P.
No 4 C Indirect By Domain Partners VII, L.P.
No 4 C Indirect By Domain Partners VII, L.P.
No 4 C Indirect By Domain Partners VII, L.P.
No 4 P Indirect By Domain Partners VII, L.P.
No 4 C Indirect By DP VII Associates, L.P.
No 4 C Indirect By DP VII Associates, L.P.
No 4 C Indirect By DP VII Associates, L.P.
No 4 C Indirect By DP VII Associates, L.P.
No 4 P Indirect By DP VII Associates, L.P.
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series A-1 Preferred Stock Disposition 2011-11-21 1,186,657 $0.00 409,192 $0.00
Common Stock Series A-2 Preferred Stock Disposition 2011-11-21 1,186,657 $0.00 409,192 $0.00
Common Stock Series B Preferred Stock Disposition 2011-11-21 2,568,521 $0.00 885,696 $0.00
Common Stock Convertible Promissory Note Disposition 2011-11-21 0 $0.00 370,799 $0.00
Common Stock Series A-1 Preferred Stock Disposition 2011-11-21 20,240 $0.00 6,979 $0.00
Common Stock Series A-2 Preferred Stock Disposition 2011-11-21 20,240 $0.00 6,979 $0.00
Common Stock Series B Preferred Stock Disposition 2011-11-21 43,809 $0.00 15,106 $0.00
Common Stock Convertible Promissory Note Disposition 2011-11-21 0 $0.00 6,324 $0.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
Footnotes
  1. All outstanding shares of the Issuer's preferred stock were automatically converted into Common Stock upon the closing of the Issuer's initial public offering (the "IPO"), for no additional consideration.
  2. The Convertible Promissory Note, plus interest accrued thereon through the closing of the IPO, automatically converted into Common Stock upon the closing of the IPO, based on the IPO price of $13.00 per share.
  3. The Reporting Person also indirectly beneficially owns 32,758 shares of Common Stock held by Domain Associates, LLC. The Reporting Person is a Managing Member of One Palmer Square Associates VII, LLC, which is the sole general partner of Domain Partners VII, L.P. and DP VII Associates, L.P. and Domain Associates, 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 beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his or her pecuniary interest therein and/or that are not actually distributed to him or her.
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