0001437749-15-011405.txt : 20150529 0001437749-15-011405.hdr.sgml : 20150529 20150529182330 ACCESSION NUMBER: 0001437749-15-011405 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150514 FILED AS OF DATE: 20150529 DATE AS OF CHANGE: 20150529 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VIVEVE MEDICAL, INC. CENTRAL INDEX KEY: 0000879682 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 043153858 STATE OF INCORPORATION: B0 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 150 COMMERCIAL STREET CITY: SUNNYVALE STATE: CA ZIP: 94086 BUSINESS PHONE: 4085301900 MAIL ADDRESS: STREET 1: 150 COMMERCIAL STREET CITY: SUNNYVALE STATE: CA ZIP: 94086 FORMER COMPANY: FORMER CONFORMED NAME: PLC SYSTEMS INC DATE OF NAME CHANGE: 19930328 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 5AM CO-INVESTORS II LP CENTRAL INDEX KEY: 0001390376 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11388 FILM NUMBER: 15900817 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL RD STE 110 CITY: MENLO PK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-233-8600 MAIL ADDRESS: STREET 1: 2200 SAND HILL RD STE 110 CITY: MENLO PK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 5AM Ventures II LP CENTRAL INDEX KEY: 0001386509 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11388 FILM NUMBER: 15900818 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL RD STE 110 CITY: Menlo Park STATE: CA ZIP: 94025 BUSINESS PHONE: 650-233-8600 MAIL ADDRESS: STREET 1: 2200 SAND HILL RD STE 110 CITY: Menlo Park STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 5AM Partners II, LLC CENTRAL INDEX KEY: 0001555952 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11388 FILM NUMBER: 15900819 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL ROAD STE 110 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650.233.8600 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD STE 110 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Schwab Andrew J. CENTRAL INDEX KEY: 0001598549 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11388 FILM NUMBER: 15900820 MAIL ADDRESS: STREET 1: C/O 5AM VENTURES, 2200 SAND HILL ROAD STREET 2: SUITE 110 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROCKLAGE SCOTT M CENTRAL INDEX KEY: 0001219014 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11388 FILM NUMBER: 15900821 MAIL ADDRESS: STREET 1: 179 SANDY POND ROAD CITY: LINCOLN STATE: MA ZIP: 01773 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DIEKMAN JOHN D CENTRAL INDEX KEY: 0001240357 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11388 FILM NUMBER: 15900822 MAIL ADDRESS: STREET 1: C/O 5 AM VENTURES STREET 2: 3000 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 4 1 rdgdoc.xml FORM 4 X0306 4 2015-05-14 0000879682 VIVEVE MEDICAL, INC. VIVMF 0001555952 5AM Partners II, LLC 2200 SAND HILL ROAD, SUITE 110 MENLO PARK CA 94025 1 0001386509 5AM Ventures II LP 2200 SAND HILL ROAD, SUITE 110 MENLO PARK CA 94025 1 0001390376 5AM CO-INVESTORS II LP 2200 SAND HILL ROAD, SUITE 110 MENLO PARK CA 94025 1 0001598549 Schwab Andrew J. 2200 SAND HILL ROAD, SUITE 110 MENLO PARK CA 94025 1 0001240357 DIEKMAN JOHN D 2200 SAND HILL ROAD, SUITE 110 MENLO PARK CA 94025 1 0001219014 ROCKLAGE SCOTT M 2200 SAND HILL ROAD, SUITE 110 MENLO PARK CA 94025 1 Common Stock 2015-05-14 4 P 0 650026 0.37 A 7310231 I See Common Stock 2015-05-14 4 P 0 25649 0.37 A 288447 I See Shares directly beneficially owned by 5AM Ventures II, L.P. Shares directly beneficially owned by 5AM Co-Investors II, L.P. 5AM Partners II, LLC is the general partner of 5AM Ventures II, L.P. and 5AM Co-Investors II, L.P. and may be deemed to have sole voting and investment power over the shares beneficially owned by 5AM Ventures II, L.P. and 5AM Co-Investors II, L.P. Dr. John Diekman, Andrew Schwab and Dr. Scott Rocklage, the managing members of 5AM Partners II, LLC, and Mark Colella, an assignee of 5AM Partners II, LLC, may be deemed to have shared voting and investment power over the shares beneficially owned by 5AM Ventures II, L.P. and 5AM Co-Investors II, L.P. Each of 5AM Partners II, LLC, Dr. Diekman, Mr. Schwab, Dr. Rocklage and Mr. Colella disclaim beneficial ownership of such shares except to the extent of its or his pecuniary interest therein. /s/ Andrew J. Schwab 2015-05-29 /s/ Dr. John D. Diekman 2015-05-29 /s/ Dr. Scott Rocklage 2015-05-29