SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
ROYSTON IVOR

(Last) (First) (Middle)
9393 TOWNE CENTRE DRIVE, #200

(Street)
SAN DIEGO, CA 92121

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/02/2005
3. Issuer Name and Ticker or Trading Symbol
FAVRILLE INC [ FVRL ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 12,048 I By Trust
Common Stock 108,432 I See Note(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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: 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 (2) (3) Common Stock 481,926 (4) I See Note(1)
Series B Convertible Preferred Stock (2) (3) Common Stock 593,737 (4) I See Note(1)
Series B-2 Convertible Preferred Stock (2) (3) Common Stock 467,829 (4) I See Note(1)
Series C Convertible Preferred Stock (2) (3) Common Stock 836,964 (5) I See Note(1)
Employee Stock Option (Right to Buy) (6) 03/18/2014 Common Stock 24,289 $0.63 D
Explanation of Responses:
1. The shares are held of record by Forward Ventures III Institutional Partners L.P., Forward Ventures III L.P., Forward Ventures IV L.P. and Forward Ventures IV B L.P. The Reporting Person is the managing member of Forward III Associates, LLC, the general partner of Forward Ventures III Institutional Partners L.P. and Forward Ventures III L.P. He is also the managing member of Forward IV Associates, LLC, the general partner of Forward Ventures IV B L.P. and Forward Ventures IV L.P. The reporting person disclaims beneficial ownership of the shares owned by such entities except to the extent of his pecuniary interest in such entities, if any.
2. Immediately.
3. Not applicable.
4. 1-for-1
5. 1.086614-for-1
6. 1/36th of the shares subject to the Stock Option vest each month commencing April 19, 2004.
Remarks:
/s/ Ivor Royston 02/02/2005
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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