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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
LDR HOLDING CORP [ LDRH ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 10/15/2013 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | 10/15/2013 | C | 471,059 | A | (1) | 471,059 | D(2) | |||
Common Stock | 10/15/2013 | C | 254,332 | A | (3) | 725,391 | D(2) | |||
Common Stock | 10/15/2013 | C | 137,450 | A | (4) | 137,450 | D(5) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 Preferred Stock | (1) | 10/15/2013 | C | 471,059 | (1) | (1) | Common Stock | 471,059 | $0 | 0 | D(2) | ||||
Series C Preferred Stock | (3) | 10/15/2013 | C | 254,332 | (3) | (3) | Common Stock | 254,332 | $0 | 0 | D(2) | ||||
Convertible Notes | (4) | 10/15/2013 | C | 137,450 | (4) | 04/25/2016(4) | Common Stock | 137,450 | $0 | 0 | D(5) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. The Series B Preferred Stock converted into the Issuer's Common Stock on a 6.75 for 1 basis and had no expiration date. |
2. Shares held directly by Fin PO S.A., SICAR ("Fin PO"). Michele Mezzarobba is the President of Fin PO and may be deemed to have beneficial ownership of the shares held by Fin PO. Fin PO is an indirect, majority-owned subsidiary of Paris Orleans SCA, a publicly-traded investment banking and asset management firm headquartered in Paris, France. Michele Mezzarobba disclaims beneficial ownership of the the Issuer's Common Stock held by the entities affiliated with Paris Orleans SCA. |
3. The Series C Preferred Stock converted into the Issuer's Common Stock on a 6.75 for 1 basis and had no expiration date. |
4. Immediately prior to the closing of the Issuer's initial public offering, the Convertible Notes were automatically converted into a number of shares of the Issuer's Common Stock equal to (a) the unpaid principal and accrued but unpaid interest on the Convertible Notes divided by (b) 50% of the price per share of the Issuer's Common Stock sold in the initial public offering. |
5. Shares held directly by PO Capinvest 1 SAS ("Capinvest"). Michele Mezzarobba is the President of Capinvest and may be deemed to have beneficial ownership of the Issuer's Common Stock held by Capinvest. Capinvest is an indirect, majority-owned subsidiary of Paris Orleans SCA, a publicly-traded investment banking and asset management firm headquartered in Paris. Michele Mezzarobba disclaims beneficial ownership of the Issuer's Common Stock held by the entities affiliated with Paris Orleans SCA. |
Remarks: |
This Form 4 is two of two Forms 4 being filed by entities affiliated with Paris Orleans SCA with respect to the Common Stock of LDR Holding Corporation |
/s/ Denise Cruz for Fin PO S.A., SICAR | 10/17/2013 | |
/s/ Denise Cruz for PO Capinvest 1 SAS | 10/17/2013 | |
/s/ Denise Cruz for Michele Mezzarobba | 10/17/2013 | |
** 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. |