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*
SANDERS CHARLES A

(Last) (First) (Middle)
C/O LIPOSCIENCE, INC.
2500 SUMNER BOULEVARD

(Street)
RALEIGH NC 27616

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/24/2013
3. Issuer Name and Ticker or Trading Symbol
LIPOSCIENCE INC [ LPDX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 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 8,730 D
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
Stock Option (right to buy) (1) 10/30/2013 Common Stock 27,281 2.5 D
Stock Option (right to buy) (2) 10/30/2013 Common Stock 18,187 2.5 D
Stock Option (right to buy) (3) 02/04/2014 Common Stock 2,182 2.5 D
Stock Option (right to buy) (4) 05/05/2015 Common Stock 4,365 2.5 D
Stock Option (right to buy) (5) 10/27/2015 Common Stock 10,912 2.5 D
Stock Option (right to buy) (6) 04/24/2018 Common Stock 14,550 2.46 D
Stock Option (right to buy) (7) 04/24/2018 Common Stock 14,550 2.46 D
Stock Option (right to buy) (8) 06/16/2018 Common Stock 29,100 2.46 D
Stock Option (right to buy) (9) 07/09/2019 Common Stock 14,550 1.88 D
Stock Option (right to buy) (10) 09/03/2020 Common Stock 14,550 4.23 D
Stock Option (right to buy) (11) 08/01/2021 Common Stock 9,700 9.84 D
Stock Option (right to buy) (12) 08/07/2022 Common Stock 9,700 11.12 D
Series E Convertible Preferred Stock (13) (13) Common Stock 1,114 (13) D
Explanation of Responses:
1. This option was fully vested upon issuance on October 30, 2003.
2. 50% of the shares underlying this option were vested upon issuance on October 30, 2003, with the remainder vesting in 12 equal monthly installments thereafter.
3. This option was fully vested upon issuance on February 4, 2004.
4. 75% of the shares underlying this option were vested upon issuance on May 5, 2005, with the remainder vesting in 3 equal monthly installments thereafter.
5. 25% of the shares underlying this option were vested upon issuance on October 27, 2005, with the remainder vesting in 9 equal monthly installments thereafter.
6. This option was fully vested upon issuance on April 24, 2008.
7. Two-thirds of the shares underlying this option were vested upon issuance on April 24, 2008, with the remainder vesting in 4 equal monthly installments thereafter.
8. 50% of the shares underlying this option vested on July 26, 2009 and the remainder vested on July 26, 2010.
9. This option vested in 12 equal monthly installments beginning on August 26, 2009.
10. 1/12 of the shares underlying this option were vested upon issuance on September 3, 2010, with the remainder vesting in 11 equal monthly installments thereafter.
11. This option vested in 12 equal monthly installments beginning on August 23, 2011.
12. This option vests in 12 equal monthly installments beginning on August 23, 2012.
13. Each share of Series E Convertible Preferred Stock is convertible, at anytime, at the holder's election, into common stock on a 0.485-for-1 basis. In addition, effective immediately prior to the closing of the issuer's initial public offering of its common stock, each share of Series E Convertible Preferred Stock will automatically convert into 0.485 shares of common stock. The Series E Convertible Preferred Stock has no expiration date.
Remarks:
Exhibit List Exhibit 24.1 - Power of Attorney
/s/ Brian F. Leaf, Attorney-in-fact 01/24/2013
** 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.