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*
Vidwans Smruti J.

(Last) (First) (Middle)
44 MONTGOMERY ST, STE 800

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/02/2015
3. Issuer Name and Ticker or Trading Symbol
CollabRx, Inc. [ CLRX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP and Chief Science Officer
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)
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
Employee Restricted Stock Unit Award (1) 01/01/2023 Common Stock 10,000 $0.00 D
Employee Stock Option (2) 07/03/2024 Common Stock 12,000 $1.99 D
Employee Stock Option (3) 12/08/2024 Common Stock 10,000 $0.75 D
Employee Stock Option (4) 07/12/2022 Common Stock 30,000 $3.94 D
Explanation of Responses:
1. The Reporting Person received 10,000 shares of the company's common stock. All 10,000 shares vested on January 1, 2015 and all shares were distributed to the reporting person.
2. The Option shall vest with respect to one-eighth or twelve and one-half percent (12.5%) of the total number of Shares subject to the Option on each of the first days of the last month of each fiscal quarter following the Vesting Commencement Date, subject to Participant's continued status as an employee on each applicable vesting date, such that all Shares subject to the Option shall be fully vested by June 1, 2016.
3. Beginning date exercisable is July 16, 2015 (or earlier, subject to certain conditions)
4. 10% of the total number of shares subject to the option vested on July 12, 2012, 15% of the total number of shares subject to the option vested on July 12, 2013, and 1/48th of the total number of shares subject to the option shall vest on the last day of each month thereafter.
Remarks:
/s/ Thomas R. Mika by Power of Attorney 04/07/2015
** 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.