0001181431-13-043632.txt : 20130808 0001181431-13-043632.hdr.sgml : 20130808 20130808150701 ACCESSION NUMBER: 0001181431-13-043632 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130808 FILED AS OF DATE: 20130808 DATE AS OF CHANGE: 20130808 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Zeltiq Aesthetics Inc CENTRAL INDEX KEY: 0001415336 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 4698 Willow Road STREET 2: Suite 100 CITY: Pleasanton STATE: CA ZIP: 94588-2710 BUSINESS PHONE: (925) 474-2500 MAIL ADDRESS: STREET 1: 4698 Willow Road STREET 2: Suite 100 CITY: Pleasanton STATE: CA ZIP: 94588-2710 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FHM V, LP CENTRAL INDEX KEY: 0001346948 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35318 FILM NUMBER: 131021495 BUSINESS ADDRESS: STREET 1: 601 UNION STREET, SUITE 3200 CITY: SEATTLE STATE: WA ZIP: 98101 BUSINESS PHONE: (206) 621-7200 MAIL ADDRESS: STREET 1: 601 UNION STREET, SUITE 3200 CITY: SEATTLE STATE: WA ZIP: 98101 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Frazier Healthcare V, LP CENTRAL INDEX KEY: 0001341169 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35318 FILM NUMBER: 131021496 BUSINESS ADDRESS: STREET 1: 601 UNION STREET, SUITE 3200 CITY: SEATTLE STATE: WA ZIP: 98101 BUSINESS PHONE: (206) 621-7200 MAIL ADDRESS: STREET 1: 601 UNION STREET, SUITE 3200 CITY: SEATTLE STATE: WA ZIP: 98101 4 1 rrd387862.xml FORM 4 X0306 4 2013-08-08 0 0001415336 Zeltiq Aesthetics Inc ZLTQ 0001341169 Frazier Healthcare V, LP 601 UNION STREET, SUITE 3200 SEATTLE WA 98101 0 0 1 0 0001346948 FHM V, LP 601 UNION STREET, SUITE 3200 SEATTLE WA 98101 0 0 1 0 Common Stock 2013-08-08 4 J 0 3000000 0 D 4427244 I See Footnote On August 8, 2013, (i) Frazier Healthcare V, L.P. ("Frazier V") distributed 3,000,000 shares of Common Stock of Zeltiq Aesthetics Inc. (the "Issuer") pro-rata to its partners for no consideration, and (ii) FHM V, L.P., the general partner of Frazier V, distributed all shares it received from Frazier V, representing FHM V, L.P.'s pro rata general partner interest in the shares held by Frazier V, pro-rata to its partners for no consideration. These distributions were made in accordance with the exemption under Rule 16a-9(a) of the Securities Exchange Act of 1934, as amended. After the distributions, Frazier V directly held 4,427,244 shares, and FHM V, L.P. did not directly hold any shares. FHM V, L.P. is the general partner of Frazier V, and FHM V, L.P. may be deemed to have voting and dispositive power with respect to the shares held directly by Frazier V. FHM V, L.P. disclaims beneficial ownership of the securities owned directly by Frazier V, except to the extent of its pecuniary interest therein. Frazier Healthcare V, L.P., By: FHM V, L.P., its general partner, By FHM V, L.L.C., its general partner, By: /s/ Steve Bailey, Chief Financial Officer 2013-08-08 FHM V, L.P., By: FHM V, L.L.C., its general partner, By: /s/ Steve Bailey, Chief Financial Officer 2013-08-08