Filing Details

Accession Number:
0000904454-11-000631
Form Type:
4
Zero Holdings:
No
Publication Time:
2011-11-21 21:04:07
Reporting Period:
2011-11-21
Filing Date:
2011-11-21
Accepted Time:
2011-11-21 21:04:07
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
1372932 Dp Vii Associates Lp C/o Domain Associates, Llc
One Palmer Square
Princeton NJ 08542
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 2011-11-21 6,979 $0.00 6,979 No 4 C Direct
Common Stiock Acquisiton 2011-11-21 6,979 $0.00 13,958 No 4 C Direct
Common Stock Acquisiton 2011-11-21 15,106 $0.00 29,064 No 4 C Direct
Common Stock Acquisiton 2011-11-21 6,324 $0.00 35,388 No 4 C Direct
Common Stock Acquisiton 2011-11-21 15,625 $13.00 51,013 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-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 Stok 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 Direct
0 No 4 C Direct
0 No 4 C Direct
0 No 4 C Direct
Footnotes
  1. All outstanding shares of the Issuer's preferred stock were automatically converted into Common Stock upon the closing of the Issuer's iniital 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.