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*
Karobath Manfred E

(Last) (First) (Middle)
C/O COLEY PHARMACEUTICAL GROUP, INC.
93 WORCESTER STREET, SUITE 101

(Street)
WELLESLEY MA 02481

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/09/2005
3. Issuer Name and Ticker or Trading Symbol
Coley Pharmaceutical Group, Inc. [ COLY ]
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 14,919 D
Series E Preferred Stock(1)(4) 8,983 D
Series F Preferred Stock(2)(4)(5) 46,379 D
Series G Preferred Stock(3)(4) 65,502 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
Options 03/27/2001 03/27/2001 Common Stock 834 $1 D
Options 12/14/2001 12/14/2001 Common Stock 7,500 $4 D
Options 10/03/2003 10/03/2003 Common Stock 70,834 $0.25 D
Options 11/23/2004 11/23/2004 Common Stock 25,000 $0.25 D
Warrant 08/09/2005 08/09/2005 Common Stock 11,358 $5.63 D
Explanation of Responses:
1. These securities will convert automatically to Common Stock on a 1 to 0.51223 basis upon the completion of the Issuer's initial public offering.
2. These securities will convert automatically to Common Stock on a 1 to 1.559824 basis upon the completion of the Issuer's initial public offering
3. These securities will convert automatically to Common Stock on a 1 to 1 basis upon the completion of the Issuer's initial public offering.
4. Gives effect for the conversion into Common Stock
5. Includes common stock issuable in connection with a guaranteed paid-in-kind dividend on Series F Preferred Stock.
Marianne Staniunas, Attorney-in-Fact 08/09/2005
** 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.