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 |
Warrant to Purchase Common Stock
|
05/30/2017 |
(2)
|
Common Stock, par value $0.00001
|
187,500
|
$
7.6
(3)
|
I
|
See footnotes
(4)
(8)
|
Warrant to Purchase Common Stock
|
05/30/2017 |
(2)
|
Common Stock, par value $0.00001
|
156,250
|
$
7.6
(3)
|
I
|
See footnotes
(5)
(8)
|
Warrant to Purchase Common Stock
|
05/30/2017 |
(2)
|
Common Stock, par value $0.00001
|
65,625
|
$
7.6
(3)
|
I
|
See footnotes
(5)
(8)
|
Warrant to Purchase Common Stock
|
05/30/2017 |
(2)
|
Common Stock, par value $0.00001
|
3,125
|
$
7.6
(3)
|
I
|
See footnotes
(5)
(8)
|
Warrant to Purchase Common Stock
|
10/19/2017 |
(2)
|
Common Stock, par value $0.00001
|
185,500
|
$
7.6
(3)
|
I
|
See footnotes
(6)
(8)
|
Series A Convertible Preferred Stock, par value $0.00001
|
(7)
|
(7)
|
Common Stock, par value $0.00001
|
300,000
|
$
(7)
|
I
|
See footnotes
(4)
(8)
|
Series A Convertible Preferred Stock, par value $0.00001
|
(7)
|
(7)
|
Common Stock, par value $0.00001
|
360,000
|
$
(7)
|
I
|
See footnotes
(5)
(8)
|
Series A-2 Convertible Preferred Stock, par value $0.00001
|
(7)
|
(7)
|
Common Stock, par value $0.00001
|
212,000
|
$
(7)
|
I
|
See footnotes
(6)
(8)
|
* |
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) |
These shares are held by SAC Acquisition LLC ("SAC"). Mr. Heyer indirectly has sole investment and dispository power over these shares. |
(2) |
Each warrant expires on the first to occur of (a) three years from the date of the earlier of (x) the Issuer's initial public offering or (y) a qualified financing, (b) the fifth anniversary of the date of issuance, or (c) the occurrence of any voluntary or involuntary liquidation, dissolution, winding up, or similar event of the Issuer. |
(3) |
Pursuant to the terms of each warrant, the exercise price of each warrant will automatically adjust to be equal to the purchase price or deemed purchase price per share of common stock in the Issuer's initial public offering. |
(4) |
These securities are held by Mistral Sac Holdings, LLC ("MSH"). Mr. Heyer indirectly has sole investment and dispository power over these securities. |
(5) |
These securities are held by Mistral Sac Holdings 3, LLC ("MSH3"). Mr. Heyer indirectly has sole investment and dispository power over these securities. |
(6) |
These securities are held by Mistral Sac Holdings 4, LLC ("MSH4"). Mr. Heyer indirectly has sole investment and dispository power over these securities. |
(7) |
Immediately prior to the completion of the Issuer's initial public offering, the preferred stock, along with the aggregate accrued or accumulated and unpaid dividends thereon, will convert into shares of the Issuer's common stock at a conversion price determined in accordance with the terms of the certificate of designations of each series of preferred stock. |
(8) |
By reason of the provisions of Rule 16a-1 of the Exchange Act, Mr. Heyer may be deemed to be beneficial owners of certain of the securities that are deemed to be beneficially owned by SAC, MSH, MSH3 and MSH4. Mr. Heyer disclaims beneficial ownership of the securities owned by SAC, MSH, MSH3 and MSH4, except to the extent of Mr. Heyer's pecuniary interest therein. |