Filing Details

Accession Number:
0001209191-15-034051
Form Type:
4
Zero Holdings:
No
Publication Time:
2015-04-14 17:22:50
Reporting Period:
2015-04-14
Filing Date:
2015-04-14
Accepted Time:
2015-04-14 17:22:50
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1348911 Carbylan Therapeutics Inc. CBYL Pharmaceutical Preparations (2834) 000000000
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1198330 P Guy Nohra C/o Acp Iv, L.p.
One Embarcadero Center, Suite 3700
San Francisco CA 94111
Yes No No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2015-04-14 727,590 $0.00 727,590 No 4 C Indirect See Footnote
Common Stock Acquisiton 2015-04-14 1,981,124 $0.00 2,708,714 No 4 C Indirect See Footnote
Common Stock Acquisiton 2015-04-14 424,346 $0.00 3,133,060 No 4 C Indirect See Footnote
Common Stock Acquisiton 2015-04-14 332,990 $0.00 3,466,050 No 4 C Indirect See Footnote
Common Stock Acquisiton 2015-04-14 877,500 $5.00 4,343,550 No 4 P Indirect See Footnote
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect See Footnote
No 4 C Indirect See Footnote
No 4 C Indirect See Footnote
No 4 C Indirect See Footnote
No 4 P Indirect See Footnote
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series A Convertible Preferred Stock Disposition 2015-04-14 727,590 $0.00 727,590 $0.00
Common Stock Series B Convertible Preferred Stock Disposition 2015-04-14 1,981,124 $0.00 1,981,124 $0.00
Common Stock Convertible Promissory Note Disposition 2015-04-14 424,346 $0.00 424,346 $0.00
Common Stock Convertible Promissory Note Disposition 2015-04-14 332,990 $0.00 332,990 $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
Footnotes
  1. Upon the closing of the Issuer's initial public offering, each share of Series A Convertible Preferred Stock and Series B Convertible Preferred Stock automatically converted into Common Stock on a one for one basis without payment or further consideration, and has no expiration date.
  2. These securities are held by ACP IV, L.P ("ACP IV"). Daniel S. Janney and Guy P. Nohra are directors of ACMP IV, LLC, the general partner of ACP IV and disclaim beneficial ownership of these securities except to the extent of any pecuniary interest therein.
  3. The Convertible Promissory Note is convertible into the number of shares of the Issuer's Common Stock equal to the quotient obtained by dividing the entire principal amount and 184 days of accrued interest on the Convertible Promissory Note by 80% of the initial public offering price of $5.00 per share of the Issuer's Common Stock, automatically upon the closing of the Issuer's initial public offering, and has no expiration date.
  4. The Convertible Promissory Note is convertible into the number of shares of the Issuer's Common Stock equal to the quotient obtained by dividing the entire principal amount and 41 days of accrued interest on the Convertible Promissory Note by 80% of the initial public offering price of $5.00 per share of the Issuer's Common Stock, automatically upon the closing of the Issuer's initial public offering, and has no expiration date.