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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Cyberkinetics Neurotechnology Systems, Inc. [ CYKN.OB ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/04/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | 11/04/2004 | P | 104,000 | A | $3 | 2,104,000 | I | See(1) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 | ||||||||
Common Stock Warrant (Right to Purchase) | $6 | 11/04/2004 | P | 34,320 | 11/04/2004 | 11/04/2009 | Common Stock | 34,320 | $0(2) | 34,320 | I | See(3) |
Explanation of Responses: |
1. Includes 1,125,000 shares already held, and 58,500 shares acquired in the reported transaction by The Global Life Science Ventures Funds II GmbH & Co. KG, and 875,000 shares already held, and 45,500 shares acquired in the reported transaction by The Global Life Science Ventures Fund II, L.P. Mr. Morgan, a director of the issuer, is (i) a director of Global Life Science (GP) Limited, general partner of The Global Life Science Ventures Fund II, L.P. and (ii) a member of the Managing Board of The GSLV Special Partner, GmbH & Co. KG, special partner of The Global Life Science Ventures Funds II, GmbH & Co. KG. Mr. Morgan disclaims beneficial ownership of all shares issued or issuable to the foregoing entities, except to the extent of his proportionate pecuniary interest, but exercises shared voting and investment power with respect to some of these shares. |
2. The warrants were issued in connection with a private financing. No value was attributed to the warrants in the financing, and none can be determined at this time. |
3. Includes warrants to purchase 19,305 shares acquired in the reported transaction by The Global Life Science Ventures Funds II GmbH & Co. KG, and warrants to purchase 15,015 shares acquired in the reported transaction by The Global Life Science Ventures Fund II, L.P. Mr. Morgan, a director of the issuer, is (i) a director of Global Life Science (GP) Limited, general partner of The Global Life Science Ventures Fund II, L.P. and (ii) a member of the Managing Board of The GSLV Special Partner, GmbH & Co. KG, special partner of The Global Life Science Ventures Funds II, GmbH & Co. KG. Mr. Morgan disclaims beneficial ownership of all shares issued or issuable to the foregoing entities, except to the extent of his proportionate pecuniary interest, but may exercise shared voting and investment power with respect to some of these warrant shares upon exercise. |
/s/ Philip W. Morgan | 11/08/2004 | |
** 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). | ||
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. |