1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series A Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
1,223,750
(1)
|
$
(1)
|
D
|
Â
|
Series B Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
797,330
(1)
|
$
(1)
|
D
|
Â
|
Series C Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
833,080
(1)
|
$
(1)
|
D
|
Â
|
Series D Convertible Preferred Stock
|
Â
(1)
|
Â
(1)
|
Common Stock
|
375,979
(1)
|
$
(1)
|
D
|
Â
|
Preferred Stock Purchase Warrant
|
Â
(2)
|
09/25/2010 |
Series B Convertible Preferred Stock
|
42,365
(2)
|
$
9
(2)
|
D
|
Â
|
Warrant to Purchase Shares of Series C Preferred Stock
|
Â
(2)
|
12/31/2007 |
Series C Convertible Preferred Stock
|
355,154
(2)
|
$
2.0048
(2)
|
D
|
Â
|
4% Senior Secured Convertible Promissory Note due 2010
|
Â
(3)
|
12/31/2010 |
Common Stock
|
$
1,544,441.51
|
$
6
(4)
|
D
|
Â
|
* |
If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** |
Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) |
The Convertible Preferred Stock is convertible into Common Stock at any time, at the holder's election, on a one-for-one basis and has no expiration date. The number of underlying shares of Common Stock reported in Column 3 reflects a 1-for-4 reverse stock split effected on June 26, 2007, pursuant to which each share of Common Stock was exchanged for 1/4 of a share of Common Stock. |
(2) |
The warrants are fully exercisable as of the date hereof. The number of underlying shares of Common Stock reported in Column 3 and the exercise price reported in Column 4 reflect a 1-for-4 reverse stock split effected on June 26, 2007, pursuant to which each share of Common Stock was exchanged for 1/4 of a share of Common Stock. Upon the closing of the issuer's initial public offering, each warrant to purchase Convertible Preferred Stock will automatically become a warrant to purchase Common Stock. |
(3) |
The note is to be automatically converted into shares of Common Stock upon the closing of the issuer's public offering or upon the consummation of a qualifying transaction resulting in a change of control of the issuer. |
(4) |
Reflects a 1-for-4 reverse stock split effected on June 26, 2007, pursuant to which each share of Common Stock was exchanged into 1/4 of a share of Common Stock. |