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*
Jordan Len

(Last) (First) (Middle)
C/O CONTROL4 CORPORATION
11734 S. ELECTION ROAD

(Street)
SALT LAKE CITY UT 84020

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CONTROL4 CORP [ CTRL ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% holder
3. Date of Earliest Transaction (Month/Day/Year)
08/07/2013
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 08/07/2013 C 2,188,168 A (1) 2,188,168 I By Frazier Technology Ventures II, L.P.(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
Series B Convertible Preferred Stock (1) 08/07/2013 C 1,419,244 (1) (1) Common Stock 1,419,244 $0.00 0 I By Frazier Technology Ventures II, L.P.(2)
Series C Convertible Preferred Stock (1) 08/07/2013 C 256,365 (1) (1) Common Stock 256,365 $0.00 0 I By Frazier Technology Ventures II, L.P.(2)
Series D Convertible Preferred Stock (1) 08/07/2013 C 188,536 (1) (1) Common Stock 188,536 $0.00 0 I By Frazier Technology Ventures II, L.P.(2)
Series G Convertible Preferred Stock (1) 08/07/2013 C 324,023 (1) (1) Common Stock 324,023 $0.00 0 I By Frazier Technology Ventures II, L.P.(2)
Explanation of Responses:
1. Each share of Issuer's Preferred Stock automatically converted into Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering of Common Stock and has no expiration date.
2. These shares are owned directly by Frazier Technology Ventures II, L.P. ("Frazier"). Frazier's sole general partner is FTVM II, L.P. ("FTVM II") and FTVM II's sole general partner is Frazier Technology Management, L.L.C. ("Frazier Tech Management"). Len Jordan is a managing member of Frazier Tech Management. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose. Len Jordan is a director of Issuer.
/s/ Len Jordan 08/07/2013
** 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).
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.