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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
WIDENSOHLER STEFAN K

(Last) (First) (Middle)
C/O CHROSAN AG, EUROPASTRASSE 18

(Street)
GLATTBRUGG/ZH V8 815

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/08/2013
3. Issuer Name and Ticker or Trading Symbol
LDR HOLDING CORP [ LDRH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 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)
Form filed by One Reporting Person
X 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 29,630 D(1)
Common Stock 146,681 D(2)
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
Series A-2 Preferred Stock (3) (3) Common Stock 66,315 (3) D(2)
Series B Preferred Stock (4) (4) Common Stock 314,040 (4) D(2)
Convertible Notes (5) 04/25/2016(5) Common Stock 105,803 (5) D(2)
1. Name and Address of Reporting Person*
WIDENSOHLER STEFAN K

(Last) (First) (Middle)
C/O CHROSAN AG, EUROPASTRASSE 18

(Street)
GLATTBRUGG/ZH V8 815

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
VERWALTUNGSGESELLSCHAFT AD. KRAUTH

(Last) (First) (Middle)
C/O BRS PARTNERSHIP, NEUER WALL 80

(Street)
HAMBURG 2M 20354

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Shares held directly by Mr. Widensholer.
2. Mr. Widensohler, is the Chief Executive Officer and Principal of Verwaltungsgesellschaft AD. KRAUTH ("KRAUTH") and may be deemed to have beneficial ownership of the shares held by KRAUTH.
3. The Series A-2 Preferred Stock is convertible into the Issuer's Common Stock on a 6.75 for 1 basis and has no expiration date.
4. The Series B Preferred Stock is convertible into the Issuer's Common Stock on a 6.75 for 1 basis and has no expiration date.
5. Immediately prior to the closing of the Issuer's initial public offering, the Convertible Notes shall automatically be converted into a number of shares of the Issuer's Common Stock equal to (a) the unpaid principal and accrued but unpaid interest on the Convertible Notes divided by (b) 50% of the price per share of the Issuer's Common Stock sold in the initial public offering.
Remarks:
Exhibit 24.1 - Confirming Statement
/s/ Denise Cruz for Stefan Widensohler 10/08/2013
/s/ Denise Cruz for Verwaltungsgesellschaft AD. KRAUTH 10/08/2013
** 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.