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) 06/18/2020 |
3. Issuer Name and Ticker or Trading Symbol
Clearside Biomedical, Inc. [ CLSD ] |
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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 | 145,000(1) | D |
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 | ||||
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. |