Filing Details

Accession Number:
0001192482-15-000206
Form Type:
4
Zero Holdings:
No
Publication Time:
2015-05-14 16:06:05
Reporting Period:
2015-05-12
Filing Date:
2015-05-14
Accepted Time:
2015-05-14 16:06:05
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1267565 Collegium Pharmaceutical Inc COLL Pharmaceutical Preparations (2834) 000000000
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1018534 D Alan Frazier C/o Frazier Healthcare Vi, L.p.
601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
1341382 N James Topper C/o Frazier Healthcare Vi, L.p.
601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
1344203 J Nader Naini C/o Frazier Healthcare Vi, L.p.
601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
1456654 Fhm Vi, L.l.c. 601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
1456655 Fhm Vi, L.p. 601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
1456656 Frazier Healthcare Vi, L.p. 601 Union Street, Suite 3200
Seattle WA 98101
No No Yes No
1531105 R Nathan Every C/o Frazier Healthcare Vi, L.p.
601 Union Street, Suite 3200
Seattle WA 98101
No No Yes 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 2015-05-12 582,490 $0.00 582,490 No 4 C Direct
Common Stock Acquisiton 2015-05-12 222,231 $0.00 804,721 No 4 C Direct
Common Stock Acquisiton 2015-05-12 392,113 $0.00 1,196,834 No 4 C Direct
Common Stock Acquisiton 2015-05-12 540,498 $0.00 1,737,332 No 4 C Direct
Common Stock Acquisiton 2015-05-12 150,000 $12.00 1,887,332 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Direct
No 4 C Direct
No 4 C Direct
No 4 C Direct
No 4 P Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series A Convertible Stock Disposition 2015-05-12 4,019,183 $0.00 582,490 $0.00
Common Stock Series B Convertible Stock Disposition 2015-05-12 1,533,399 $0.00 222,231 $0.00
Common Stock Series C Convertible Stock Disposition 2015-05-12 2,705,585 $0.00 392,113 $0.00
Common Stock Series D Convertible Stock Disposition 2015-05-12 3,676,078 $0.00 540,498 $0.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Direct
0 No 4 C Direct
0 No 4 C Direct
0 No 4 C Direct
Footnotes
  1. All series of Convertible Preferred Stock automatically converted into Collegium Pharmaceutical, Inc. common stock on a 1-for-6.9 basis immediately prior to the closing of the initial public offering and had no expiration date.
  2. Reflects the conversion of preferred stock into Collegium Pharmaceutical, Inc. common stock on a 1-for-6.9 basis which became effective on May 12, 2015.
  3. This report is filed jointly by Frazier Healthcare VI, L.P. ("FHVI"), FHM VI, L.P. ("FHM LP"), FHM VI, LLC ("FHM LLC"), Nathan Every ("Every"), Alan Frazier ("Frazier"), Patrick Heron ("Heron"), Nader Naini ("Naini") and James Topper ("Topper"). The shares are held by FHVI. The general partner of FHVI is FHM LP, a limited partnership, the general partner of which is FHM LLC. The members of FHM LLC are Every, Frazier, Naini, Heron, and Topper. These individuals share voting and investment power over the shares held by FHVI. Each of these individuals disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest.