Filing Details

Accession Number:
0001192482-15-000207
Form Type:
4
Zero Holdings:
No
Publication Time:
2015-05-14 16:06:49
Reporting Period:
2015-05-12
Filing Date:
2015-05-14
Accepted Time:
2015-05-14 16:06:49
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
1365617 J Patrick Heron C/O Frazier Healthcare Vi, L.p.
601 Union Street, Suite 3200
Seattle WA 98101
Yes 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 Indirect By Frazier Healthcare VI, L.P.
Common Stock Acquisiton 2015-05-12 222,231 $0.00 804,721 No 4 C Indirect By Frazier Healthcare VI, L.P.
Common Stock Acquisiton 2015-05-12 392,113 $0.00 1,196,834 No 4 C Indirect By Frazier Healthcare VI, L.P.
Common Stock Acquisiton 2015-05-12 540,498 $0.00 1,737,332 No 4 C Indirect By Frazier Healthcare VI, L.P.
Common Stock Acquisiton 2015-05-12 150,000 $12.00 1,887,332 No 4 P Indirect By Frazier Healthcare VI, L.P.
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect By Frazier Healthcare VI, L.P.
No 4 C Indirect By Frazier Healthcare VI, L.P.
No 4 C Indirect By Frazier Healthcare VI, L.P.
No 4 C Indirect By Frazier Healthcare VI, L.P.
No 4 P Indirect By Frazier Healthcare VI, L.P.
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 Indirect
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
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. The shares are held by Frazier Healthcare VI, L.P. The general partner of Frazier Healthcare VI, L.P. is FHM VI, L.P., a limited partnership, the general partner of which is FHM VI, LLC. The members of FHM VI, LLC are Dr. Nathan Every, Alan Frazier, Nader Naini, Patrick Heron, and Dr. James Topper. These individuals share voting and investment power over the shares held by Frazier Healthcare VI, L.P. Mr. Heron disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest.