0001209191-11-042502.txt : 20110804
0001209191-11-042502.hdr.sgml : 20110804
20110804171536
ACCESSION NUMBER: 0001209191-11-042502
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110802
FILED AS OF DATE: 20110804
DATE AS OF CHANGE: 20110804
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Johann Peter
CENTRAL INDEX KEY: 0001369942
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35238
FILM NUMBER: 111011315
MAIL ADDRESS:
STREET 1: C/O NGN CAPITAL BERGHEIMER STR. 89A
CITY: HEIDELBERG
STATE: 2M
ZIP: D69115
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HORIZON PHARMA, INC.
CENTRAL INDEX KEY: 0001492426
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 272179987
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1033 SKOKIE BLVD
STREET 2: SUITE 355
CITY: NORTHBROOK
STATE: IL
ZIP: 60062
BUSINESS PHONE: 224-383-3000
MAIL ADDRESS:
STREET 1: 1033 SKOKIE BLVD
STREET 2: SUITE 355
CITY: NORTHBROOK
STATE: IL
ZIP: 60062
4
1
doc4.xml
FORM 4 SUBMISSION
X0304
4
2011-08-02
0
0001492426
HORIZON PHARMA, INC.
HZNP
0001369942
Johann Peter
C/O HORIZON PHARMA, INC.
1033 SKOKIE BLVD., SUITE 355
NORTHRIDGE
IL
60062
1
0
0
0
Common Stock
2011-08-02
4
C
0
401927
A
401927
I
See FN
Common Stock
2011-08-02
4
C
0
555956
A
957883
I
See FN
Common Stock
2011-08-02
4
C
0
44364
A
1002247
I
See FN
Common Stock
2011-08-02
4
C
0
61366
A
1063613
I
See FN
Common Stock
2011-08-02
4
C
0
89652
9.00
A
1153265
I
See FN
Common Stock
2011-08-02
4
C
0
124007
9.00
A
1277272
I
See FN
Common Stock
2011-08-02
4
P
0
81671
9.00
A
1358943
I
See FN
Common Stock
2011-08-02
4
P
0
112968
9.00
A
1471911
I
See FN
Common Stock
1523642
I
See FN
Common Stock
1595198
I
See FN
Series A Convertible Preferred Stock
2011-08-02
4
C
0
401927
0.00
D
Common Stock
401927
0
I
See FN
Series A Convertible Preferred Stock
2011-08-02
4
C
0
555956
0.00
D
Common Stock
555956
0
I
See FN
Series B Convertible Preferred Stock
2011-08-02
4
C
0
44364
0.00
D
Common Stock
44364
0
I
See FN
Series B Convertible Preferred Stock
2011-08-02
4
C
0
61366
0.00
D
Common Stock
61366
0
I
See FN
Convertible Promissory Notes
9.00
2011-08-02
4
C
0
806879.04
0.00
D
Common Stock
89652
0
I
See FN
Convertible Promissory Notes
9.00
2011-08-02
4
C
0
1116079.76
0.00
D
Common Stock
124007
0
I
See FN
Automatic conversion, in connection with the Issuer's initial public offering, of preferred stock into shares of common stock. Every 2.374 shares of preferred stock converted into one share of common stock upon the closing of the Issuer's initial public offering.
The securities are held of record by NGN Biomed Opportunity I GmbH & Co. Beteiligungs KG ("NGN Biomed").
The reporting person is a Managing General Partner of NGN Capital LLC, which is the general partner of the general partner of NGN BioMed and is the managing limited partner of NGN BioMed GMBH. The Reporting Person disclaims beneficial ownership with respect to these securities, except to the extent of his pecuniary interest therein.
The securities are held of record by NGN Biomed Opportunity I, L.P. ("NGN Biomed").
Represents shares acquired upon conversion, in connection with the Issuer's initial public offering, of convertible promissory notes.
These securities are preferred stock of the Issuer and did not have an expiration date. Prior to the Issuer's initial public offering of common stock, the securities were convertible at any time at the election of the holder. The securities automatically converted into shares of common stock upon the closing of the issuer's initial public offering of common stock.
Principal and accrued interest converted upon the Issuer's initial public offering of common stock, into shares of common stock.
/s/ Robert J. De Vaere, Attorney-in-Fact
2011-08-04