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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 08/11/2012 |
3. Issuer Name and Ticker or Trading Symbol
KALOBIOS PHARMACEUTICALS INC [ NONE ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 | 572,295 | D(1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 B-1 Preferred Stock | (2) | (3) | Common Stock | 445,847 | (2) | D(4) | |
Series B-2 Preferred Stock | (2) | (3) | Common Stock | 624,999 | (2) | D(5) | |
Series C Preferred Stock | (2) | (3) | Common Stock | 284,513 | (2) | D(6) | |
Series D Preferred Stock | (2) | (3) | Common Stock | 344,084 | (2) | D(7) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. The shares are held as follows: 500,758 shares by 5AM Ventures LLC ("Ventures") and 71,537 shares by 5AM Co-Investors LLC ("Co-Investors"). 5AM Partners LLC is the general partner of Ventures and Co-Investors. The managing directors of 5AM Partners LLC are Dr. John D. Diekman and Andrew J. Schwab. |
2. Each share of Preferred Stock is convertible at any time, at the election of the holder, into one fully paid and nonassessable share of Common Stock, subject to certain anti-dilution adjustments. |
3. No expiration. |
4. The shares are held as follows: 390,116 shares by Ventures and 55,731 shares by Co-Investors. |
5. The shares are held as follows: 546,874 shares by Ventures and 78,125 shares by Co-Investors. |
6. The shares are held as follows: 249,360 shares by Ventures and 35,153 shares by Co-Investors. |
7. The shares are held as follows: 301,570 shares by Ventures and 42,514 shares by Co-Investors. |
Remarks: |
Each Reporting Persons disclaim beneficial ownership of shares of KaloBios Pharmaceuticals, Inc. stock held by the other Reporting Person herein, except to the extent of their respective pecuniary interest therein, if any. The filing of this statement shall not be deemed an admission that, for purposes of Section 16 of the Securities Exchange Act of 1934, or otherwise, any of the Reporting Persons are the beneficial owners of all of the equity securities covered by this statement. |
/s/ John D. Diekman, Managing Director of 5AM Partners LLC | 08/10/2012 | |
/s/ John D. Diekman, Managing Director of 5AM Partners LLC, the general partner of 5AM Ventures LLC | 08/10/2012 | |
/s/ John D. Diekman, Managing Director of 5AM Partners LLC, the general partner of 5AM Co-Investors LLC | 08/10/2012 | |
** 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. |