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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Ciulla Thomas

(Last) (First) (Middle)
C/O CLEARSIDE BIOMEDICAL, INC.
900 NORTH POINT PARKWAY, SUITE 200

(Street)
ALPHARETTA GA 30005

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/18/2020
3. Issuer Name and Ticker or Trading Symbol
Clearside Biomedical, Inc. [ CLSD ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Medical 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)
Common Stock 145,000(1) D
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 Stock Option (right to buy) (2) 10/24/2028 Common Stock 80,000 $5.04 D
Employee Stock Option (right to buy) (3) 02/05/2029 Common Stock 100,000 $1.24 D
Employee Stock Option (right to buy) (4) 01/08/2030 Common Stock 75,000 $2.37 D
Explanation of Responses:
1. Includes 70,000 restricted stock units ("RSUs"). Fifty percent (50%) of the shares underlying these RSUs vest on September 18, 2020 and twenty-five percent (25%) of the remaining RSUs vest in four equal quarterly installments thereafter. Also includes an additional 50,000 RSUs. Twenty-five percent (25%) of the shares underlying these RSUs vest in four equal annual installments on January 8, 2021, January 8, 2022, January 8, 2023 and January 8, 2024. Each RSU represents a contingent right to receive one share of common stock of the Issuer. Vesting is subject to the Reporting Person's continuous service as of each such vesting date, and subject to accelerated vesting in specified circumstances.
2. One-fourth of the shares underlying this option vested on October 24, 2019 and the balance of the shares vested or vest in a series of 36 successive equal monthly installments thereafter, subject to the reporting person's continuous service as of each such vesting date.
3. One-fourth of the shares underlying this option vested on February 5, 2020 and the balance of the shares vested or vest in a series of 36 successive equal monthly installments thereafter, subject to the reporting person's continuous service as of each such vesting date.
4. One-fourth of the shares underlying this option vest on January 8, 2021 and the balance of the shares vest in a series of 36 successive equal monthly installments thereafter, subject to the reporting person's continuous service as of each such vesting date.
Remarks:
Exhibit List - Exhibit 24 - Power of Attorney
/s/ Mark Ballantyne, Attorney-in-Fact 06/26/2020
** 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.