Filing Details
- Accession Number:
- 0001104659-11-064948
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2011-11-17 19:05:39
- Reporting Period:
- 2011-11-16
- Filing Date:
- 2011-11-17
- Accepted Time:
- 2011-11-17 19:05:39
- SEC Url:
- Form 4 Filing
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 |
|---|---|---|---|---|---|---|---|
| 1456589 | Versant Ventures Iv, Llc | 3000 Sand Hill Road Bldg 4, Suite 210 Menlo Park CA 94025 | No | No | Yes | No | |
| 1456590 | Versant Venture Capital Iv, L.p. | 3000 Sand Hill Road Bldg 4, Suite 210 Menlo Park CA 94025 | No | No | Yes | No | |
| 1456591 | Versant Side Fund Iv, L.p. | 3000 Sand Hill Road Bldg 4, Suite 210 Menlo Park CA 94025 | 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 | 2011-11-16 | 661,323 | $0.00 | 2,159,289 | No | 4 | P | Indirect | See Footnote |
| Common Stock | Acquisiton | 2011-11-16 | 4,165 | $0.00 | 13,600 | No | 4 | P | Indirect | See Footnote |
| Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|
| No | 4 | P | 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-1 Convertible Preferred Stock | Acquisiton | 2011-11-16 | 295,404 | $0.00 | 295,404 | $0.00 |
| Common Stock | Series A-1 Convertible Preferred Stock | Acquisiton | 2011-11-16 | 1,861 | $0.00 | 1,861 | $0.00 |
| Common Stock | Series A-2 Convertible Preferred Stock | Acquisiton | 2011-11-16 | 295,404 | $0.00 | 295,404 | $0.00 |
| Common Stock | Series A-2 Convertible Preferred Stock | Acquisiton | 2011-11-16 | 1,861 | $0.00 | 1,861 | $0.00 |
| Common Stock | Series B Convertible Preferred Stock | Acquisiton | 2011-11-16 | 639,403 | $0.00 | 639,403 | $0.00 |
| Common Stock | Series B Convertible Preferred Stock | Acquisiton | 2011-11-16 | 4,027 | $0.00 | 4,027 | $0.00 |
| Common Stock | Convertible Promissory Note | Acquisiton | 2011-11-16 | 267,755 | $0.00 | 267,755 | $0.00 |
| Common Stock | Convertible Promissory Note | Acquisiton | 2011-11-16 | 1,686 | $0.00 | 1,686 | $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
- Each share of Series A-1 Convertible Preferred Stock automatically converted into shares of Common Stock on a 1 for 1 basis immediately prior to the closing of the Issuer's initial public offering and had no expiration date
- Each share of Series A-2 Convertible Preferred Stock automatically converted into shares of Common Stock on a 1 for 1 basis immediately prior to the closing of the Issuer's initial public offering and had no expiration date
- Each share of Series B Convertible Preferred Stock automatically converted into shares of Common Stock on a 1 for 1 basis immediately prior to the closing of the Issuer's initial public offering and had no expiration date.
- The outstanding principal amount and all accrued and unpaid interest automatically converted into Common Stock at a rate of $13.00 per share, which was the Company's initial public offering price.
- The shares are held by Versant Venture Capital IV, L.P. ("Versant IV"). In their capacity as managing members of Versant Ventures IV, LLC which is the general partner of Versant IV, Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen share voting and investment authority over the shares held by the Versant IV and may be deemed to beneficially own the shares. Each of Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen disclaim beneficial ownership of these shares except to the extent of his or her pecuniary interest therein.
- The shares are held by Versant Side Fund IV, L.P. ("Versant Side"). In their capacity as managing members of Versant Ventures IV, LLC which is the general partner of Versant Side, Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen share voting and investment authority over the shares held by the Versant Side and may be deemed to beneficially own the shares. Each of Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen disclaim beneficial ownership of these shares except to the extent of his or her pecuniary interest therein.
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