0001140361-17-038320.txt : 20171011 0001140361-17-038320.hdr.sgml : 20171011 20171011170102 ACCESSION NUMBER: 0001140361-17-038320 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20171011 FILED AS OF DATE: 20171011 DATE AS OF CHANGE: 20171011 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TAYLOR CRAIG C CENTRAL INDEX KEY: 0000939105 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38238 FILM NUMBER: 171133050 MAIL ADDRESS: STREET 1: 400 HAMILTON AVE. STREET 2: 4TH FLOOR CITY: PALO ALTO STATE: CA ZIP: 94301 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Restoration Robotics Inc CENTRAL INDEX KEY: 0001409269 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 061681204 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 128 BAYTECH DRIVE CITY: SAN JOSE STATE: CA ZIP: 95134 BUSINESS PHONE: 408-883-6888 MAIL ADDRESS: STREET 1: 128 BAYTECH DRIVE CITY: SAN JOSE STATE: CA ZIP: 95134 3 1 doc1.xml FORM 3 X0206 3 2017-10-11 0 0001409269 Restoration Robotics Inc HAIR 0000939105 TAYLOR CRAIG C C/O RESTORATION ROBOTICS, INC. 128 BAYTECH DRIVE SAN JOSE CA 95134 1 0 1 0 Series A Preferred Stock Common Stock 12466 I See Footnote Series A Preferred Stock Common Stock 461717 I See Footnote Series A Preferred Stock Common Stock 474184 I See Footnote Series B Preferred Stock Common Stock 13650 I See Footnote Series B Preferred Stock Common Stock 505580 I See Footnote Series B Preferred Stock Common Stock 519230 I See Footnote Series C Preferred Stock Common Stock 16643 I See Footnote Series C Preferred Stock Common Stock 616446 I See Footnote Series C Preferred Stock Common Stock 633094 I See Footnote The shares of the Issuer's Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1 basis immediately prior to the consummation of the Issuer's Initial Public Offering (the "IPO"). The expiration date is not relevant to the conversion of these securities. The shares are directly held by Alloy Partners 2002, L.P. ("Alloy Partners 2002"). Alloy Ventures 2002, LLC ("Ventures 2002"), as the sole general partner of Alloy Partners 2002, may be deemed to beneficially own the shares held by Alloy Partners 2002. The Reporting Person is a managing director of Ventures 2002, and as such may be deemed to beneficially own the shares held by Alloy Partners 2002. The Reporting Person disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein. The shares are directly held by Alloy Ventures 2002, L.P. ("Alloy Ventures 2002"). Ventures 2002, as the sole general partner of Alloy Ventures 2002, may be deemed to beneficially own the shares held by Alloy Ventures 2002. The Reporting Person is a managing director of Ventures 2002, and as such may be deemed to beneficially own the shares held by Alloy Ventures 2002. The Reporting Person disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein. The shares are directly held by Alloy Ventures 2005, L.P. ("Alloy Ventures 2005"). Alloy Ventures 2005, LLC ("Ventures 2005"), as the sole general partner of Alloy Ventures 2005, may be deemed to beneficially own the shares held by Alloy Ventures 2005. The Reporting Person is a managing director of Ventures 2005, and as such may be deemed to beneficially own the shares held by Alloy Ventures 2005. The Reporting Person disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein. /s/ Charlotte Holland, Attorney-in-Fact for Craig C Taylor 2017-10-11 EX-24 2 poa_taylor.htm
Restoration Robotics, Inc.

Power of Attorney

Know all by these presents, that the undersigned hereby constitutes and appoints each of (i) the Chief Executive Officer of Restoration Robotics, Inc., a Delaware corporation (the “Company”), who is currently Ryan Rhodes and (ii) the Company’s Chief Financial Officer, who is currently Charlotte Holland, and their respective successors (including anyone serving in such capacities on an interim or acting basis), signing singly, with full powers of substitution, as the undersigned’s true and lawful attorney-in-fact to:

1.
prepare, execute in the undersigned’s name and on the undersigned’s behalf, and submit to the U.S. Securities and Exchange Commission (the “SEC”) a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC;

2.
execute for and on behalf of the undersigned, in the undersigned’s capacity as an officer and/or director of the Company, Forms 3, 4, and 5 and any amendments thereto in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;

3.
do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and

4.
take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact’s discretion.

The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact’s substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned’s responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned’s holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 14th day of June, 2017.

 
/s/ Craig Taylor
 
By: Craig Taylor