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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 04/19/2012 |
3. Issuer Name and Ticker or Trading Symbol
INFOBLOX INC [ BLOX ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 | 88,490 | I | By Tenaya Capital IV, L.P.(1) |
Common Stock | 103,745 | I | By Tenaya Capital IV-C, L.P.(2) |
Common Stock | 108,114 | I | By Tenaya Capital IV-P, L.P.(3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 D Convertible Preferred Stock | (4) | (4) | Common Stock | 385,610 | (4) | I | By Tenaya Capital IV, L.P.(1) |
Series D Convertible Preferred Stock | (4) | (4) | Common Stock | 368,650 | (4) | I | By Tenaya Capital IV-C, L.P.(2) |
Series D Convertible Preferred Stock | (4) | (4) | Common Stock | 384,172 | (4) | I | By Tenaya Capital IV-P, L.P.(3) |
Series E Convertible Preferred Stock | (5) | (5) | Common Stock | 461,851 | (5) | I | By Tenaya Capital IV, L.P.(1) |
Series E Convertible Preferred Stock | (5) | (5) | Common Stock | 624,914 | (5) | I | By Tenaya Capital IV-C, L.P.(2) |
Series E Convertible Preferred Stock | (5) | (5) | Common Stock | 651,226 | (5) | I | By Tenaya Capital IV-P, L.P.(3) |
Explanation of Responses: |
1. The reporting person is one of the managing members of Tenaya Capital IV Annex GP, LLC, which is the general partner of Tenaya Capital IV, L.P. ("Tenaya Capital IV"), and may be deemed to share voting and dispositive power with respect to the shares held by Tenaya Capital IV. The reporting person disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. |
2. The reporting person is one of the managing members of Tenaya Capital IV GP, LLC, which is the general partner of Tenaya Capital IV GP, LP, which is the general partner of Tenaya Capital IV-C, L.P. ("Tenaya Capital IV-C"), and may be deemed to share voting and dispositive power with respect to the shares held by Tenaya Capital IV-C. The reporting person disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. |
3. The reporting person is one of the managing members of Tenaya Capital IV GP, LLC, which is the general partner of Tenaya Capital IV, GP, LP, which is the general partner of Tenaya Capital IV-P, L.P. ("Tenaya Capital IV-P"), and may be deemed to share voting and dispositive power with respect to the shares held by Tenaya Capital IV-P. The reporting person disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. |
4. Each share of the issuer's Series D Convertible Preferred Stock will be automatically converted into 1/3 share of the issuer's Common Stock immediately upon the closing of the issuer's sale of its Common Stock in its firm commitment underwritten initial public offering pursuant to a registration statement on Form S-1 under the Securities Act of 1933, as amended, and has no expiration date. |
5. Each share of the issuer's Series E Convertible Preferred Stock will be automatically converted into 1/3 share of the issuer's Common Stock immediately upon the closing of the issuer's sale of its Common Stock in its firm commitment underwritten initial public offering pursuant to a registration statement on Form S-1 under the Securities Act of 1933, as amended, and has no expiration date. |
Remarks: |
/s/ Robert Horton as attorney-in-fact for Thomas E. Banahan | 04/19/2012 | |
** 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. |