SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
HARRISON DONALD C

(Last) (First) (Middle)
525 UNIVERSITY AVENUE, SUITE 1400

(Street)
PALO ALTO CA 94301

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AtriCure, Inc. [ ATRC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
08/10/2005
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 08/10/2005 C 127,502 A $0(1) 193,291 D
Common Stock 08/10/2005 C 749,500 A $0(1) 749,500 I Held by CLS I-IV, LLC(2)
Common Stock 08/10/2005 C 8,989 A $0(1) 8,989 I Held by Charter Advisors Fund IV, L.P.(4)
Common Stock 08/10/2005 C 28,506 A $0(1) 28,506 I Held by Charter Entrepreneurs Fund IV, L.P.(6)
Common Stock 08/10/2005 S 82,028 D $11.16 667,472 I Held by CLS I-IV, LLC(2)
Common Stock 08/10/2005 S 937 D $11.16 8,052 I Held by Charter Advisors Fund IV, L.P.(4)
Common Stock 08/10/2005 S 2,972 D $11.16 25,534 I Held by Charter Entrepreneurs Fund IV, L.P.(6)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Convertible Preferred Stock (1) 08/10/2005 C 98,135 (1) (1) Common Stock 98,135 $0(1) 0 D
Series B Convertible Preferred Stock (1) 08/10/2005 C 29,367 (1) (1) Common Stock 29,367 $0(1) 0 D
Series A Convertible Preferred Stock (1) 08/10/2005 C 397,809 (1) (1) Common Stock 397,809 $0(1) 0 I Held by CLS I-IV, LLC(2)
Series A Convertible Preferred Stock (1) 08/10/2005 C 4,771 (1) (1) Common Stock 4,771 $0(1) 0 I Held by Charter Advisors Fund IV, L.P.(4)
Series A Convertible Preferred Stock (1) 08/10/2005 C 15,130 (1) (1) Common Stock 15,130 $0(1) 0 I Held by Charter Entrepreneurs Fund IV, L.P.(6)
Series B Convertible Preferred Stock (1) 08/10/2005 C 351,691 (1) (1) Common Stock 351,691 $0(1) 0 I Held by CLS I-IV, LLC(2)
Series B Convertible Preferred Stock (1) 08/10/2005 C 4,218 (1) (1) Common Stock 4,218 $0(1) 0 I Held by Charter Advisors Fund IV, L.P.(4)
Series B Convertible Preferred Stock (1) 08/10/2005 C 13,376 (1) (1) Common Stock 13,376 $0(1) 0 I Held by Charter Entrepreneurs Fund IV, L.P.(6)
Preferred Stock Warrants (Right to Buy) $5.43 08/10/2005 C 8,810 08/10/2005 (3) Series B Convertible Preferred Stock 8,810 $0(5) 0 D
Preferred Stock Warrants (Right to Buy) $5.43 08/10/2005 C 34,833 08/10/2005 (3) Series B Convertible Preferred Stock 34,833 $0(5) 0 I Held by CLS I-IV, LLC(2)
Preferred Stock Warrants (Right to Buy) $5.43 08/10/2005 C 661 08/10/2005 (3) Series B Convertible Preferred Stock 661 $0(5) 0 I Held by Charter Advisors Fund IV, L.P.(4)
Preferred Stock Warrants (Right to Buy) $5.43 08/10/2005 C 1,865 08/10/2005 (3) Series B Convertible Preferred Stock 1,865 $0(5) 0 I Held by Charter Entrepreneurs Fund IV, L.P.(6)
Common Stock Warrants (Right to Buy) $5.43 08/10/2005 C 8,810 08/10/2005 (3) Common Stock 8,810 $0(5) 8,810 D
Common Stock Warrants (Right to Buy) $5.43 08/10/2005 C 34,833 08/10/2005 (3) Common Stock 34,833 $0(5) 34,833 I Held by CLS I-IV, LLC(2)
Common Stock Warrants (Right to Buy) $5.43 08/10/2005 C 661 08/10/2005 (3) Common Stock 661 $0(5) 661 I Held by Charter Advisors Fund IV, L.P.(4)
Common Stock Warrants (Right to Buy) $5.43 08/10/2005 C 1,865 08/10/2005 (3) Common Stock 1,865 $0(5) 1,865 I Held by Charter Entrepreneurs Fund IV, L.P.(6)
Explanation of Responses:
1. The shares of Preferred Stock automatically converted on a 1-for-1 basis into Common Stock upon the closing of the Issuer's initial public offering.
2. Dr. Harrison is a manager of CLS I-IV, LLC and disclaims beneficial ownership of the securities held by this entity, except as to his pecuniary interest therein.
3. Warrants expire on August 10, 2006 (one year from the date of the Issuer's initial public offering).
4. Dr. Harrison disclaims beneficial ownership of the securities held by this entity, except as to his pecuniary interest therein.
5. The shares of Series B Convertible Preferred Stock issuable upon conversion of the Warrants automatically converted on a 1-for-1 basis into Common Stock upon the closing of the Issuer's initial public offering.
6. Dr. Harrison disclaims beneficial ownership of the securities held by this entity, except as to his pecuniary interest therein.
/s/ Thomas J. Etergino as Attorney-in-Fact for Donald C. Harrison 08/15/2005
** 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 4 (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).
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