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*
Lanfear Dennis M

(Last) (First) (Middle)
COHERUS BIOSCIENCES, INC.
201 REDWOOD SHORES PARKWAY, SUITE 200

(Street)
REDWOOD CITY CA 94065

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/06/2014
3. Issuer Name and Ticker or Trading Symbol
Coherus BioSciences, Inc. [ CHRS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
See Remarks
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, $0.0001 par value 50,989 D
Common Stock, $0.0001 par value 1,358,728 I By Revocable Trust(1)
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
Series B Preferred Stock (2) (3) Common Stock 14,509 $0.00 D
Series B Preferred Stock (2) (3) Common Stock 3,193 $0.00 I By Revocable Trust(1)
Series A Preferred Stock (2) (3) Common Stock 40,159 $0.00 I By LLC(4)
Series B Preferred Stock (2) (3) Common Stock 21,527 $0.00 I By LLC(4)
Series C Preferred Stock (2) (3) Common Stock 5,286 $0.00 I By LLC(4)
Warrant to Purchase Series A Preferred Stock (5) 01/26/2016 Series A Preferred Stock 19,976 $1.2503 I By LLC(4)
Warrant to Purchase Series B Preferred Stock (5) 07/21/2018 Series B Preferred Stock 3,225 $0.0167 D
Stock Option (Right to Buy) (6) 10/11/2020 Common Stock 29,994 $0.0083 D
Stock Option (Right to Buy) (7) 07/17/2021 Common Stock 331,054 $0.4168 D
Stock Option (Right to Buy) (8) 11/21/2023 Common Stock 299,940 $1.417 D
Stock Option (Right to Buy) (9) 03/10/2024 Common Stock 480,739 $1.667 D
Stock Option (Right to Buy) (9) 03/10/2024 Common Stock 418,638 $1.667 D
Explanation of Responses:
1. These shares are held by the Lanfear Revocable Trust, dated January 27, 2004, as restated, of which Reporting Person is a trustee.
2. The Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock automatically convert into shares of Issuer's Common Stock on a 1:1 basis immediately prior to the completion of Issuer's initial public offering.
3. The expiration date is not relevant to the conversion of these securities.
4. These shares are held by Lanfear Capital Advisors, LLC of which Reporting Person is President.
5. The warrant is immediately exercisable.
6. The shares underlying this option are fully vested and exercisable as of the date hereof.
7. A portion of the shares underlying this option are vested and exercisable as of the date hereof. The original vesting schedule is as follows: Twenty Five Percent (25%) of the shares subject to the option vest one year measured from April 19, 2011 (the "Vesting Commencement Date") and the remaining shares subject to the option vest in 36 successive, equal monthly installments thereafter on each monthly anniversary of the Vesting Commencement Date, subject to Reporting Person's continued service relationship with the Issuer on each such vesting date.
8. A portion of the shares underlying this option are vested and exercisable as of the date hereof. The original vesting schedule is as follows: The underlying shares subject to the option vest and become exercisable in successive, equal monthly installments over four years measured from July 20, 2013, subject to Reporting Person's continued service relationship with the Issuer on each such vesting date.
9. A portion of the shares underlying this option are vested and exercisable as of the date hereof. The original vesting schedule is as follows: The underlying shares subject to the option vest and become exercisable in successive, equal monthly installments over four years measured from March 11, 2014, subject to Reporting Person's continued service relationship with the Issuer on each such vesting date.
Remarks:
President and Chief Executive Officer
/s/ Matthew R. Hooper, as Attorney-in-Fact for Dennis M. Lanfear 11/06/2014
** 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).
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.