-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, MSXQrKHNrPhxYFcHuEdQGBAMwsbxjHi5edJGd4DUAh7XpnZNHItnAc6ruNcmiRMs C747MMuTk6h7eeAJB9xfsQ== 0001012975-10-000025.txt : 20100128 0001012975-10-000025.hdr.sgml : 20100128 20100128110133 ACCESSION NUMBER: 0001012975-10-000025 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100126 FILED AS OF DATE: 20100128 DATE AS OF CHANGE: 20100128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CHAMBON PHILIPPE CENTRAL INDEX KEY: 0001192212 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552441 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NIEDEL JAMES CENTRAL INDEX KEY: 0001231092 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552440 MAIL ADDRESS: STREET 1: C/O CREDIT SUISSE PRIVATE EQUITY INC STREET 2: 11 MADISON AVE CITY: NEW YORK STATE: NY ZIP: 10010 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HUNT RONALD CENTRAL INDEX KEY: 0001247851 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552437 MAIL ADDRESS: STREET 1: C/O CREDIT SUISSE 1ST BOSTON PRV EQY STREET 2: 11 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10010 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAPORTE KATHLEEN CENTRAL INDEX KEY: 0001196201 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552438 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lathi Vijay K CENTRAL INDEX KEY: 0001340806 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552439 MAIL ADDRESS: STREET 1: C/O NEW LEAF VENTURE PARTNERS STREET 2: 3000 SAND HILL ROAD, BLDG 3; SUITE 170 CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: WORLD HEART CORP CENTRAL INDEX KEY: 0001024520 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4750 WILEY POST WAY STREET 2: SUITE 120 CITY: SALT LAKE CITY STATE: UT ZIP: 84116 BUSINESS PHONE: 801-355-6255 MAIL ADDRESS: STREET 1: 4750 WILEY POST WAY STREET 2: SUITE 120 CITY: SALT LAKE CITY STATE: UT ZIP: 84116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AKKARAJU SRINIVAS CENTRAL INDEX KEY: 0001253170 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552436 MAIL ADDRESS: STREET 1: NEW LEAF VENTURES STREET 2: 2500 SAND HILL ROAD, SUITE 203 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: New Leaf Ventures II, L.P. CENTRAL INDEX KEY: 0001441439 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552444 BUSINESS ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 1603 CITY: NEW YORK STATE: NY ZIP: 10036 BUSINESS PHONE: (646) 871-6400 MAIL ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 1603 CITY: NEW YORK STATE: NY ZIP: 10036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: New Leaf Venture Management II, L.L.C. CENTRAL INDEX KEY: 0001441857 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552442 BUSINESS ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 1603 CITY: NEW YORK STATE: NY ZIP: 10036 BUSINESS PHONE: 646 871-6400 MAIL ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 1603 CITY: NEW YORK STATE: NY ZIP: 10036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: New Leaf Venture Associates II, L.P. CENTRAL INDEX KEY: 0001441858 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28882 FILM NUMBER: 10552443 BUSINESS ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 1603 CITY: NEW YORK STATE: NY ZIP: 10036 BUSINESS PHONE: 646 871-6400 MAIL ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 1603 CITY: NEW YORK STATE: NY ZIP: 10036 4 1 edgar.xml PRIMARY DOCUMENT X0303 4 2010-01-26 0001024520 WORLD HEART CORP WHRT 0001441439 New Leaf Ventures II, L.P. C/O NEW LEAF VENTURES TIMES SQUARE TWR, 7 TIMES SQ, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001441858 New Leaf Venture Associates II, L.P. C/O NEW LEAF VENTURES TIMES SQUARE TWR, 7 TIMES SQ, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001441857 New Leaf Venture Management II, L.L.C. C/O NEW LEAF VENTURES TIMES SQUARE TWR, 7 TIMES SQ, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001192212 CHAMBON PHILIPPE C/O NEW LEAF VENTURES TIMES SQUARE TWR, 7 TIMES SQ, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001231092 NIEDEL JAMES C/O NEW LEAF VENTURES TIMES SQUARE TWR, 7 TIMES SQ, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001340806 Lathi Vijay K C/O NEW LEAF VENTURES 2500 SAND HILL ROAD, SUITE 203 MENLO PARK CA 94025 0 0 1 0 0001196201 LAPORTE KATHLEEN C/O NEW LEAF VENTURES 2500 SAND HILL ROAD, SUITE 203 MENLO PARK CA 94025 0 0 1 0 0001247851 HUNT RONALD C/O NEW LEAF VENTURES TIMES SQUARE TWR, 7 TIMES SQ, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001253170 AKKARAJU SRINIVAS C/O NEW LEAF VENTURES 2500 SAND HILL ROAD, SUITE 203 MENLO PARK CA 94025 0 0 1 0 Common Stock 2010-01-26 4 P 0 388350 5.15 A 3721683 D Warrants (right to buy) 4.90 2010-01-26 4 P 0 388350 5.15 A 2010-01-26 2011-04-26 Common Stock 388350 388350 D Warrants (right to buy) 4.90 2010-01-26 4 P 0 388350 5.15 A 2010-01-26 2015-01-26 Common Stock 388350 776700 D Represents the per unit purchase price of a share of common stock, a 15-month warrant to purchase one share of common stock and a five-year warrant to purchase one share of common stock. The securities are directly held by New Leaf Ventures II, L.P. ("NLV II") and indirectly held by New Leaf Venture Associates II, L.P. ("NLV Associates"), the sole general partner of NLV II, New Leaf Venture Management II, L.L.C. ("NLV Management"), the sole general partner of NLV Associates, and the individual managers of NLV Management (NLV Associates, NLV Management and the individual managers of NLV Management each, an "Indirect Reporting Person"). The individual managers of NLV Management filing jointly with NLV II, NLV Associates and NLV Management are Philippe O. Chambon, James Niedel, Vijay Lathi, Kathleen LaPorte, Ronald Hunt and Srinivas Akkaraju. Each Indirect Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the NLV II shares and warrants in which such Indirect Reporting Person has no actual pecuniary interest therein.< /footnote> /s/ Craig L. Slutzkin, Chief Financial Officer of New Leaf Venture Management II, L.L.C., the sole general partner of New Leaf Venture Associates II, L.P., the sole general partner of New Leaf Ventures II, L.P. 2010-01-28 /s/ Craig L. Slutzkin, Chief Financial Officer of New Leaf Venture Management II, L.L.C., the sole general partner of New Leaf Venture Associates II, L.P. 2010-01-28 /s/ Craig L. Slutzkin, Chief Financial Officer of New Leaf Venture Management II, L.L.C. 2010-01-28 /s/ Craig L. Slutzkin, as Attorney-in-Fact for Philippe O. Chambon 2010-01-28 /s/ Craig L. Slutzkin, as Attorney-in-Fact for James Niedel 2010-01-28 /s/ Craig L. Slutzkin, as Attorney-in-Fact for Vijay Lathi 2010-01-28 /s/ Craig L. Slutzkin, as Attorney-in-Fact for Kathleen LaPorte 2010-01-28 /s/ Craig L. Slutzkin, as Attorney-in-Fact for Ronald Hunt 2010-01-28 /s/ Craig L. Slutzkin, as Attorney-in-Fact for Srinivas Akkaraju 2010-01-28 -----END PRIVACY-ENHANCED MESSAGE-----