0001209191-14-057611.txt : 20140912
0001209191-14-057611.hdr.sgml : 20140912
20140912100449
ACCESSION NUMBER: 0001209191-14-057611
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140909
FILED AS OF DATE: 20140912
DATE AS OF CHANGE: 20140912
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ATWOOD BRIAN G
CENTRAL INDEX KEY: 0001266567
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099812
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 4 SUITE 210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: COLELLA SAMUEL D
CENTRAL INDEX KEY: 0001201580
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099814
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD, 4-210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MILDER DONALD B
CENTRAL INDEX KEY: 0001279660
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099815
MAIL ADDRESS:
STREET 1: 3000 SAND HILL RD
STREET 2: BUILDING 4, SUITE 210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LUBASH BARBARA N
CENTRAL INDEX KEY: 0001279592
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099816
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD # 4-210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LINK WILLIAM J PHD
CENTRAL INDEX KEY: 0001228684
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099817
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD, #4-210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Versant Side Fund II, LP
CENTRAL INDEX KEY: 0001354307
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099820
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BLDG. 4, STE. 210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BLDG. 4, STE. 210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Versant Venture Capital II, LP
CENTRAL INDEX KEY: 0001354131
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099821
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BLDG. 4, STE. 210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BLDG. 4, STE. 210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Inogen Inc
CENTRAL INDEX KEY: 0001294133
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 326 BOLLAY DRIVE
CITY: GOLETA
STATE: CA
ZIP: 93117
BUSINESS PHONE: 805-562-0500
MAIL ADDRESS:
STREET 1: 326 BOLLAY DRIVE
CITY: GOLETA
STATE: CA
ZIP: 93117
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Versant Ventures II LLC
CENTRAL INDEX KEY: 0001354727
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099818
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL RD., #4-210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: 3000 SAND HILL RD., #4-210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: JAFFE ROSS A MD
CENTRAL INDEX KEY: 0001181338
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099813
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD, #4-210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Versant Affiliates Fund II-A, LP
CENTRAL INDEX KEY: 0001354132
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36309
FILM NUMBER: 141099819
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BLDG. 4, STE. 210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BLDG. 4, STE. 210
CITY: MENLO PARK
STATE: CA
ZIP: 94025
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2014-09-09
0
0001294133
Inogen Inc
INGN
0001354727
Versant Ventures II LLC
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001228684
LINK WILLIAM J PHD
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001279592
LUBASH BARBARA N
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001279660
MILDER DONALD B
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001201580
COLELLA SAMUEL D
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001181338
JAFFE ROSS A MD
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001266567
ATWOOD BRIAN G
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001354131
Versant Venture Capital II, LP
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001354307
Versant Side Fund II, LP
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
0001354132
Versant Affiliates Fund II-A, LP
3000 SAND HILL ROAD, STE 4-210
MENLO PARK
CA
94025
0
0
1
0
Common Stock
2014-09-09
4
S
0
7388
23.2496
D
62733
I
see footnore
Common Stock
2014-09-09
4
J
0
3476
0.00
D
29537
I
see footnote
Common Stock
2014-09-09
4
J
0
389136
0.00
D
3306680
I
see footnote
Common Stock
2014-09-09
4
J
0
194
0.00
A
194
I
see footnote
Common Stock
2014-09-09
4
J
0
388
0.00
A
388
I
see footnote
Common Stock
2014-09-09
4
J
0
243
0.00
A
243
I
see footnote
Common Stock
2014-09-09
4
J
0
243
0.00
A
243
I
see footnote
Common Stock
2014-09-09
4
J
0
486
0.00
A
486
I
see footnote
Common Stock
2014-09-09
4
J
0
243
0.00
A
243
I
see footnote
Price reflected is the weighted-average sale price for shares sold. The range of sale prices for the transactions reported was $22.71 to $23.91 per share. Each Reporting Person undertakes to provide, upon request by the SEC staff, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price.
Shares held by Versant Affiliates Fund II-A, L.P. ("VAF II-A"). Versant Ventures II, LLC ("VVC II") serves as the sole general partner of VAF II-A. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VVC II and share voting and dispositive power over the shares held by VAF II-A, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
Represents a pro-rata in-kind distribution of Common Stock of the Issuer to the partners of Versant Side Fund II, L.P. ("VSF II") without the receipt of consideration.
Shares held by VSF II. VVC II serves as the sole general partner of VSF II. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VVC II and share voting and dispositive power over the shares held by VSF II, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
Represents a pro-rata in-kind distribution of Common Stock of the Issuer to the partners of Versant Venture Capital II, L.P. ("VV II") without the receipt of consideration.
Shares held by VV II. VVC II serves as the sole general partner of VV II. Brian G. Atwood, Samuel D. Colella, Ross A. Jaffe, William J. Link, Ph.D., Donald B. Milder, Rebecca B. Robertson, Bradley J. Bolzon, Charles M. Warden, and Barbara N. Lubash are directors and/or members of VVC II and share voting and dispositive power over the shares held by VV II, however, each disclaim beneficial ownership of these shares, except to the extent of their pecuniary interest in such shares.
Represents receipt of an in-kind distribution of Common Stock from VSF II to its limited partners.
Shares held by Atwood-Edminster Trust dated 4/2/2000 for the benefit of Brian G. Atwood.
Shares held by Colella Family Partners and Colella Family Trust UTA Dated 9/21/92 for the benefit of Samuel D. Colella.
Shares held by Jaffe Family Trust for the benefit of Ross A. Jaffe.
Shares held by Link Family Trust, dated May 19, 2005 for the benefit of William J. Link.
Shares held by Milder Community Property Trust Dated 11/7/91, as amended and restated 11/20/98 for the benefit of Donald B. Milder.
Shares held by Robertson Family Trust U/D/T 5/7/98 for the benefit of Rebecca B. Robertson.
1 of 2
/s/ Robin L. Praeger
2014-09-11