SEC Form 4
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*
Lichter Jay

(Last) (First) (Middle)
C/O AVALON VENTURES
1134 KLINE STREET

(Street)
LA JOLLA CA 92037

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
OTONOMY, INC. [ OTIC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
08/31/2017
4. 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 Acquired, Disposed of, or Beneficially Owned
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 08/31/2017 M(1) 141,060 A $14.18 2,406,212 I See Footnote(2)
Common Stock 08/31/2017 F(1) 108,851 D $18.37 2,297,361 I See Footnote(2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 11/04/2018 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 12/08/2018 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 01/14/2019 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 04/13/2019 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 07/01/2019 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 10/08/2019 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 12/15/2019 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 01/22/2020 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 04/01/2020 Common Stock 14,106 $0.00 0 I See Footnote(2)
Warrant to Purchase Common Stock (Right to Buy) $14.18 08/31/2017 M(1) 14,106 08/18/2014 05/28/2020 Common Stock 14,106 $0.00 0 I See Footnote(2)
Explanation of Responses:
1. On August 31, 2017, Avalon Ventures VIII, L.P. ("Avalon VIII LP") exercised certain warrants to purchase an aggregate of 141,060 shares of the Issuer's common stock at an exercise price of $14.18 per share. Avalon VIII LP paid the exercise price of the warrants on a cashless basis, resulting in the Issuer's withholding of 108,851 of the shares of common stock to pay the exercise price and the issuance to Avalon VIII LP of 32,209 shares.
2. The reported securities are held of record by Avalon VIII LP. The Reporting Person is a managing director of Avalon Ventures VIII GP, LLC, the general partner of Avalon VIII LP, and disclaims beneficial ownership of the securities held by Avalon VIII LP except to the extent of any pecuniary interest therein.
Remarks:
/s/ Jay Lichter, Ph.D. 09/05/2017
** 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).
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