-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, PiCZ8VY7VQJn5gSt6hUCW8jz3+0e+cLc7WFljZFgGNdGO1bjm4dz1LKHyNTSsmwX 1T6yxwVdecX5M8ut1Bfvfw== 0000950005-04-000154.txt : 20040213 0000950005-04-000154.hdr.sgml : 20040213 20040213124402 ACCESSION NUMBER: 0000950005-04-000154 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040213 GROUP MEMBERS: FOURTH MDV PARTNERS, L.L.C. GROUP MEMBERS: JONATHAN D. FEIBER GROUP MEMBERS: LAWRENCE G. MOHR, JR. GROUP MEMBERS: MDV IV ENTREPRENEURS' NETWORK FUND, L.P. GROUP MEMBERS: MOHR, DAVIDOW VENTURES IV, L.P. GROUP MEMBERS: NANCY J. SCHOENDORF GROUP MEMBERS: WILLIAM H. DAVIDOW SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FORMFACTOR INC CENTRAL INDEX KEY: 0001039399 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 133711155 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-79547 FILM NUMBER: 04596557 BUSINESS ADDRESS: STREET 1: 2140 RESEARCH DRIVE CITY: LIVERMORE STATE: CA ZIP: 94550 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: MOHR DAVIDOW VENTURES IV L P CENTRAL INDEX KEY: 0001093293 IRS NUMBER: 943218929 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 2775 SABD HILL RD SUITE 240 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6508547236 MAIL ADDRESS: STREET 1: 2775 SAND HILL ROAD STREET 2: SUITE 240 CITY: MENLO PARK STATE: CA ZIP: 94025 SC 13G 1 p18193_sc13g.txt SCHEDULE 13G -------------------------- OMB APPROVAL -------------------------- OMB Number: 3235-0145 Expires: December 31, 2005 Estimated average burden hours per response......11 -------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 ------------ SCHEDULE 13G INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1 (b), (c) AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO 13d-2 (b) FormFactor, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 346375108 - -------------------------------------------------------------------------------- (CUSIP Number) December 31, 2003 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: |_| Rule 13d-1(b) |_| Rule 13d-1(c) |X| Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). (Continued on following pages) Page 1 of 14 Pages Exhibit Index on Page 13 CUSIP No. 346375108 Page 2 of 14 Pages - -------------------------------------------------------------------------------- 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Mohr, Davidow Ventures IV, L.P. ("MDV IV") - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |X| - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 3,433,557 shares, except that Fourth MDV Partners, L.L.C. ("Fourth MDV Partners"), the general partner of MDV IV, may be deemed to have sole voting power, and Lawrence G. Mohr ("Mohr"), William H. Davidow ("Davidow"), Jonathan D. Feiber ("Feiber"), and Nancy Schoendorf ("Schoendorf"), the members of Fourth MDV Partners, may be deemed to have shared power to vote these shares. -------------------------------------------------------- NUMBER OF 6 SHARED VOTING POWER SHARES BENEFICIALLY See response to row 5. OWNED BY -------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING PERSON 3,433,557 shares, except that Fourth MDV Partners, the WITH general partner of MDV IV, may be deemed to have sole dispositive power, and Mohr, Davidow, Feiber, and Schoendorf, the members of Fourth MDV Partners, may be deemed to have shared power to dispose of these shares. -------------------------------------------------------- 8 SHARED DISPOSITIVE POWER See response to row 7. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 3,433,557 shares. - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 9.59% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* PN - -------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! CUSIP No. 346375108 Page 3 of 14 Pages - -------------------------------------------------------------------------------- 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) MDV IV Entrepreneurs' Network Fund, L.P. ("MDV IV Entrepreneurs' Network Fund") - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |X| - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 131,487 shares, except that Fourth MDV Partners, L.L.C. ("Fourth MDV Partners"), the general partner of MDV IV Entrepreneurs' Network Fund, may be deemed to have sole voting power, and Lawrence G. Mohr ("Mohr"), William H. Davidow ("Davidow"), Jonathan D. Feiber ("Feiber"), and Nancy Schoendorf ("Schoendorf"), the members of Fourth MDV Partners, may be deemed to have shared power to vote these shares. -------------------------------------------------------- NUMBER OF 6 SHARED VOTING POWER SHARES BENEFICIALLY See response to row 5. OWNED BY -------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING PERSON 131,487 shares, except that Fourth MDV Partners, the WITH general partner of MDV IV Entrepreneurs' Network Fund, may be deemed to have sole dispositive power, and Mohr, Davidow, Feiber, and Schoendorf, the members of Fourth MDV Partners, may be deemed to have shared power to dispose of these shares. -------------------------------------------------------- 8 SHARED DISPOSITIVE POWER See response to row 7. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 131,487 shares. - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 0.37% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* PN - -------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! CUSIP No. 346375108 Page 4 of 14 Pages - -------------------------------------------------------------------------------- 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Fourth MDV Partners, L.L.C. ("Fourth MDV Partners") - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |X| - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 3,565,044 shares, 3,433,557 of which are directly owned by MDV IV and 131,487 of which are directly owned by MDV IV Entrepreneurs' Network Fund. Fourth MDV Partners, the general partner of MDV IV and MDV IV Entrepreneurs' Network Fund, may be deemed to have sole voting power, and Mohr, Davidow, Feiber, and Schoendorf, the members of Fourth MDV Partners, may be deemed to have shared power to vote these shares. -------------------------------------------------------- NUMBER OF 6 SHARED VOTING POWER SHARES BENEFICIALLY See response to row 5. OWNED BY -------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING PERSON 3,565,044 shares, 3,433,557 of which are directly owned WITH by MDV IV and 131,487 of which are directly owned by MDV IV Entrepreneurs' Network Fund. Fourth MDV Partners, the general partner of MDV IV and MDV IV Entrepreneurs' Network Fund, may be deemed to have sole dispositive power, and Mohr, Davidow, Feiber, and Schoendorf, the members of Fourth MDV Partners, may be deemed to have shared power to dispose of these shares. -------------------------------------------------------- 8 SHARED DISPOSITIVE POWER See response to row 7. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 3,565,044 shares. - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 9.96% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* OO - -------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! CUSIP No. 346375108 Page 5 of 14 Pages - -------------------------------------------------------------------------------- 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Lawrence G. Mohr, Jr. ("Mohr") - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |X| - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S. Citizen - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 0 shares. -------------------------------------------------------- NUMBER OF 6 SHARED VOTING POWER SHARES BENEFICIALLY 3,565,044 shares, of which 3,433,557 are directly owned OWNED BY by MDV IV and 131,487 are directly owned by MDV IV EACH Entrepreneurs' Network Fund. Mohr is a general partner REPORTING of Fourth MDV Partners, the general partner of MDV IV PERSON and MDV IV Entrepreneurs' Network Fund, and may be deemed to have shared power to vote these shares. -------------------------------------------------------- 7 SOLE DISPOSITIVE POWER 0 shares. -------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 3,565,044 shares, of which 3,433,557 are directly owned by MDV IV and 131,487 are directly owned by MDV IV Entrepreneurs' Network Fund. Mohr is a general partner of Fourth MDV Partners, the general partner of MDV IV and MDV IV Entrepreneurs' Network Fund, and may be deemed to have shared power to dispose of these shares. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 3,565,044 shares. - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 9.96% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! CUSIP No. 346375108 Page 6 of 14 Pages - -------------------------------------------------------------------------------- 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) William H. Davidow ("Davidow") - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |X| - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S. Citizen - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 160,361 shares. -------------------------------------------------------- NUMBER OF 6 SHARED VOTING POWER SHARES BENEFICIALLY 3,640,044 shares, of which 3,433,557 are directly owned OWNED BY by MDV IV, 131,487 are directly owned by MDV IV EACH Entrepreneurs' Network Fund and 75,000 are directly REPORTING owned by Chachagua Partnership ("Chachagua"). Davidow is PERSON a general partner of Fourth MDV Partners, the general partner of MDV IV and MDV IV Entrepreneurs' Network Fund, and a general partner of Chachagua, and may be deemed to have shared power to vote these shares. Davidow disclaims beneficial ownership of the securities held by Chachagua except to the extent of his indirect pecuniary interest therein. -------------------------------------------------------- 7 SOLE DISPOSITIVE POWER 160,361 shares. -------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 3,640,044 shares, of which 3,433,557 are directly owned by MDV IV, 131,487 are directly owned by MDV IV Entrepreneurs' Network Fund and 75,000 are directly owned by Chachagua. Davidow is a general partner of Fourth MDV Partners, the general partner of MDV and MDV IV Entrepreneurs' Network Fund, and a general partner of Chachagua, and may be deemed to have shared power to dispose of these shares. Davidow disclaims beneficial ownership of the securities held by Chachagua except to the extent of his indirect pecuniary interest therein. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 3,800,405 shares. - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 10.62% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! CUSIP No. 346375108 Page 7 of 14 Pages - -------------------------------------------------------------------------------- 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Jonathan D. Feiber ("Feiber") - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |X| - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S. Citizen - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 0 shares. -------------------------------------------------------- NUMBER OF 6 SHARED VOTING POWER SHARES BENEFICIALLY 3,565,044 shares, of which 3,433,557 are directly owned OWNED BY by MDV IV and 131,487 are directly owned by MDV IV EACH Entrepreneurs' Network Fund. Feiber is a general partner REPORTING of Fourth MDV Partners, the general partner of MDV IV PERSON and MDV IV Entrepreneurs' Network Fund, and may be deemed to have shared power to vote these shares. -------------------------------------------------------- 7 SOLE DISPOSITIVE POWER 0 shares. -------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 3,565,044 shares, of which 3,433,557 are directly owned by MDV IV and 131,487 are directly owned by MDV IV Entrepreneurs' Network Fund. Feiber is a general partner of Fourth MDV Partners, the general partner of MDV IV and MDV IV Entrepreneurs' Network Fund, and may be deemed to have shared power to dispose of these shares. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 3,565,044 shares. - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 9.96% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! CUSIP No. 346375108 Page 8 of 14 Pages - -------------------------------------------------------------------------------- 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Nancy J. Schoendorf ("Schoendorf") - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |X| - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S. Citizen - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 0 shares. -------------------------------------------------------- NUMBER OF 6 SHARED VOTING POWER SHARES BENEFICIALLY 3,565,044 shares, of which 3,433,557 are directly owned OWNED BY by MDV IV and 131,487 are directly owned by MDV IV EACH Entrepreneurs' Network Fund. Schoendorf is a general REPORTING partner of Fourth MDV Partners, the general partner of PERSON MDV IV and MDV IV Entrepreneurs' Network Fund, and may be deemed to have shared power to vote these shares. -------------------------------------------------------- 7 SOLE DISPOSITIVE POWER 0 shares. -------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 3,565,044 shares, of which 3,433,557 are directly owned by MDV IV and 131,487 are directly owned by MDV IV Entrepreneurs' Network Fund. Schoendorf is a general partner of Fourth MDV Partners, the general partner of MDV IV and MDV IV Entrepreneurs' Network Fund, and may be deemed to have shared power to dispose of these shares. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 3,565,044 shares. - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 9.96% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! CUSIP No. 346375108 Page 9 of 14 Pages ITEM 1(a). NAME OF ISSUER: FormFactor, Inc. ITEM 1(b). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES: 2140 Research Drive Livermore, California 94550 ITEM 2(a). NAME OF PERSON FILING: This statement is filed by Mohr, Davidow Ventures IV, L.P., a Delaware limited partnership ("MDV IV"), MDV IV Entrepreneurs' Network Fund, L.P., a Delaware limited partnership ("MDV IV Entrepreneurs' Network Fund"), Fourth MDV Partners, L.L.C., a Delaware limited liability company ("Fourth MDV Partners"), Lawrence G. Mohr ("Mohr"), William H. Davidow ("Davidow"), Jonathan D. Feiber ("Feiber"), and Nancy Schoendorf ("Schoendorf"). The foregoing entities and individuals are collectively referred to as the "Reporting Persons". Fourth MDV Partners is the general partner of MDV IV and MDV IV Entrepreneurs' Network Fund, and may be deemed to have sole power to vote and sole power to dispose of shares of the issuer directly owned by MDV IV and MDV IV Entrepreneurs' Network Fund. Mohr, Davidow, Feiber, and Schoendorf are the general partners/managing members of Fourth MDV Partners, and may be deemed to have shared power to vote and shared power to dispose of the shares of issuer directly owned by MDV IV and MDV IV Entrepreneurs' Network Fund. ITEM 2(b). ADDRESS OF PRINCIPAL BUSINESS OFFICE, OR, IF NONE, RESIDENCE: The address of the principal business office for each of the Reporting Persons is: Mohr, Davidow Ventures 2775 Sand Hill Road, Suite 240 Menlo Park, California 94025 ITEM 2(c) CITIZENSHIP: MDV IV and MDV IV Entrepreneurs' Network Fund, are Delaware limited partnerships. Fourth MDV Partners is a Delaware limited liability company. Mohr, Davidow, Feiber, and Schoendorf are United States citizens. ITEM 2(d). TITLE OF CLASS OF SECURITIES: Common Stock ITEM 2(e). CUSIP NUMBER: 346375108 ITEM 3. Not Applicable CUSIP No. 346375108 Page 10 of 14 Pages ITEM 4. OWNERSHIP: The following information with respect to the ownership of the Common Stock of the issuer by the persons filing this Statement is provided as of December 31, 2003: (a) Amount beneficially owned: See Row 9 of cover page for each Reporting Person. (b) Percent of Class: See Row 11 of cover page for each Reporting Person. (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote: See Row 5 of cover page for each Reporting Person. (ii) Shared power to vote or to direct the vote: See Row 6 of cover page for each Reporting Person. (iii) Sole power to dispose or to direct the disposition of: See Row 7 of cover page for each Reporting Person. (iv) Shared power to dispose or to direct the disposition of: See Row 8 of cover page for each Reporting Person. CUSIP No. 346375108 Page 11 of 14 Pages ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS: Not applicable. ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON: Under certain circumstances set forth in the limited partnership agreements of MDV IV and MDV IV Entrepreneurs' Network Fund and the limited liability company agreement of Fourth MDV, the general and limited partners of each of such entities may be deemed to have the right to receive dividends from, or the proceeds from, the sale of shares of the issuer owned by each such entity of which they are a partner. ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY: Not applicable. ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP: Not applicable. ITEM 9. NOTICE OF DISSOLUTION OF GROUP: Not applicable. ITEM 10. CERTIFICATION: Not applicable. CUSIP No. 346375108 Page 12 of 14 Pages SIGNATURES After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Dated: February 13, 2004 By: /s/ Nancy J. Schoendorf --------------------------------------- Nancy J. Schoendorf, individually, and on behalf of MDV IV, in her capacity as a managing member of Fourth MDV Partners, the general partner of MDV IV, on behalf of MDV IV Entrepreneurs' Network Fund, in her capacity as a managing member of Fourth MDV, the general partner of MDV IV Entrepreneurs' Network Fund, and on behalf of Fourth MDV Partners in her capacity as a managing member thereof. By: /s/ William H. Davidow --------------------------------------- William H. Davidow By: /s/ Jonathan D. Feiber --------------------------------------- Jonathan D. Feiber By: /s/ Lawrence G. Mohr, Jr. --------------------------------------- Lawrence G. Mohr, Jr. CUSIP No. 346375108 Page 13 of 14 Pages EXHIBIT INDEX Found on Sequentially Exhibit Numbered Page - ------- ------------- Exhibit A: Agreement of Joint Filing 14 CUSIP No. 346375108 Page 14 of 14 Pages EXHIBIT A The undersigned hereby agree that a single Schedule 13G (or any amendment thereto) relating to the Common Stock of FormFactor, Inc. shall be filed on behalf of each of the undersigned and that this Agreement shall be filed as an exhibit to such Schedule 13G. February 13, 2004 By: /s/ Nancy J. Schoendorf --------------------------------------- Nancy J. Schoendorf, individually, and on behalf of MDV IV, in her capacity as a managing member of Fourth MDV Partners, the general partner of MDV IV, on behalf of MDV IV Entrepreneurs' Network Fund, in her capacity as a managing member of Fourth MDV, the general partner of MDV IV Entrepreneurs' Network Fund, and on behalf of Fourth MDV Partners in her capacity as a managing member thereof. By: /s/ William H. Davidow --------------------------------------- William H. Davidow By: /s/ Jonathan D. Feiber --------------------------------------- Jonathan D. Feiber By: /s/ Lawrence G. Mohr, Jr. --------------------------------------- Lawrence G. Mohr, Jr. -----END PRIVACY-ENHANCED MESSAGE-----