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*
HEALTHCARE VENTURES VII LP

(Last) (First) (Middle)
47 THORNDIKE STREET
SUITE B1-1

(Street)
CAMBRIDGE MA 02141

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/01/2014
3. Issuer Name and Ticker or Trading Symbol
GLOBEIMMUNE INC [ GBIM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
07/01/2014
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)
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
Warrant to Purchase Series B Convertible Preferred Stock (1) 07/08/2019(2) Common Stock 5,172(2) $42(2) D
Warrant to Purchase Series C Convertible Preferred Stock (1) 07/08/2019(2) Common Stock 3,714(2) $45.36(2) D
1. Name and Address of Reporting Person*
HEALTHCARE VENTURES VII LP

(Last) (First) (Middle)
47 THORNDIKE STREET
SUITE B1-1

(Street)
CAMBRIDGE MA 02141

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
HealthCare Partners VII, L.P.

(Last) (First) (Middle)
47 THORNDIKE STREET
SUITE B1-1

(Street)
CAMBRIDGE MA 02141

(City) (State) (Zip)

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

(Last) (First) (Middle)
C/O HEALTHCARE VENTURES LLC
47 THORNDIKE STREET, SUITE B1-1

(Street)
CAMBRIDGE MA 02141

(City) (State) (Zip)

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

(Last) (First) (Middle)
C/O HEALTHCARE VENTURES LLC
47 THORNDIKE STREET, SUITE B1-1

(Street)
CAMBRIDGE MA 02141

(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*
LITTLECHILD JOHN W

(Last) (First) (Middle)
C/O HEALTHCARE VENTURES LLC
47 THORNDIKE STREET, SUITE B1-1

(Street)
CAMBRIDGE MA 02141

(City) (State) (Zip)

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

(Last) (First) (Middle)
C/O HEALTHCARE VENTURES LLC
47 THORNDIKE STREET, SUITE B1-1

(Street)
CAMBRIDGE MA 02141

(City) (State) (Zip)

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

(Last) (First) (Middle)
C/O HEALTHCARE VENTURES LLC
47 THORNDIKE STREET, SUITE B1-1

(Street)
CAMBRIDGE MA 02141

(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. Immediately exercisable.
2. This amendment to the Form 3 (the "Original Form 3") filed by the reporting persons on July 1, 2014 is being filed to update the expiration dates of the Warrant to Purchase Series B Convertible Preferred Stock and the Warrant to Purchase Series C Preferred Stock (each, a "Warrant"). The Original Form 3 reported the expiration dates of the Warrants as June 30, 2015 and May 14, 2019, respectively, but the expiration date of each Warrant is the later of such date and the date five years after completion of the Issuer's initial public offering (the "IPO"), July 8, 2019. In addition the number of shares of common stock underlying each Warrant and the exercise price of each Warrant have been restated to reflect the 1 for 31.39 conversion of the issuer's preferred stock into common stock upon the closing of the IPO.
Remarks:
/s/Jeffrey B. Steinberg, Administrative Partner of HealthCare Ventures VII, L.P. 07/17/2014
Jeffrey B. Steinberg, Administrative Partner of HealthCare Partners VII, L.P. 07/17/2014
Jeffrey B. Steinberg, Attorney-in-Fact for James Cavanaugh 07/17/2014
Jeffrey B. Steinberg, Attorney-in-Fact for Augustine Lawlor 07/17/2014
Jeffrey B. Steinberg, Attorney-in-Fact for John Littlechild 07/17/2014
Jeffrey B. Steinberg, Attorney-in-Fact for Christopher Mirabelli 07/17/2014
Jeffrey B. Steinberg, Attorney-in-Fact for Harold Werner 07/17/2014
** 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).
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