FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
METABASIS THERAPEUTICS INC [ MBRX ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 06/21/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 06/21/2004 | C | 1,979,270 | A | (1) | 1,979,270(2) | D | |||
Common Stock | 06/21/2004 | C | 94,782 | A | (1) | 94,782(3) | I | See footnote(3) | ||
Common Stock | 06/21/2004 | P | 124,059 | A | $7 | 124,059(2) | D | |||
Common Stock | 06/21/2004 | P | 5,941 | A | $7 | 5,941(3) | I | See footnote(3) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series C Convertible Preferred Stock | (4) | 06/21/2004 | C | 782,411 | (5) | (6) | Common Stock | 782,411(2) | (6) | 0 | D | ||||
Series C Convertible Preferred Stock | (4) | 06/21/2004 | C | 37,468 | (5) | (6) | Common Stock | 37,468(3) | (6) | 0 | I | See footnote(3) | |||
Series D Convertible Preferred Stock | (7) | 06/21/2004 | C | 539,815 | (5) | (6) | Common Stock | 539,815(2) | (6) | 0 | D | ||||
Series D Convertible Preferred Stock | (7) | 06/21/2004 | C | 25,850 | (5) | (6) | Common Stock | 25,850(3) | (6) | 0 | I | See footnote(3) | |||
Series E Convertible Preferred Stock | (8) | 06/21/2004 | C | 657,044 | (5) | (6) | Common Stock | 657,044(2) | (6) | 0 | D | ||||
Series E Convertible Preferred Stock | (8) | 06/21/2004 | C | 31,464 | (5) | (6) | Common Stock | 31,464(3) | (6) | 0 | I | See footnote(3) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. N/A - Securities were issued upon conversion of convertible preferred stock. |
2. Securities held of record by InterWest Partners VII, LP (IP7) and are under common control with InterWest Investors VII, OP (II7). InterWest Management Partners VII, LLC is the general partner of IP7 and II7. Harvey B. Cash, Phillip T. Gianos, W. Scott Hedrick, W. Stephen Holmes, Gilbert H. Kliman, Thomas L. Rosch and Arnold L. Oronsky are Managing Members, Each member of the group disclaims beneficial ownership of such shares, expect to the extent of his pecuniary interest therein. |
3. Securities held of record by Interwest Partners VII, LP (II7) are under common control with IP7. Harvey B. Cash, Phillip T. Gianos, W. Scott Hedrick, W. Stephen Holmes, Gilbert H. Kliman, Thomas L. Rosch and Arnold L. Ornosky are managing members. Each member of the group disclaims beneficial ownership of such shares, expect to the extent of his pecuniary interest therein. |
4. Each share of Series C Preferred Stock converted into 0.1646 of a share of Common Stock upon the completion of the issuer's initial public offering. |
5. Immediate |
6. N/A |
7. Each share of Series D Convertible Stock converted into 0.17 of a share of Common Stock upon the completion of the issuer's initial public offering. |
8. Each share of Series E Convertible Stock converted into 0.1646 of a share of Common Stock upon the completion of the issuer's initial public offering. |
Remarks: |
This Form 4 is being filed in conjunction with a Form 4 filed on behalf of InterWest Partners VII, LP of even date herewith, in order to report more than 10 joint filers. Each such Form 4 relates to the same reportable transaction which occurred on June 21, 2004, and such Form 4s shall be treated as one filing. |
Arnold L. Oronsky, Managing Director of InterWest Management Partners, LLC, General Partner of InterWest Partners VII, LP | 06/21/2004 | |
Arnold L. Oronsky, Managing Director of InterWest Management Partners VII, LLC, General Partner of InterWest Investors VII, LP | 06/21/2004 | |
Arnold L. Oronsky, Managing Director of InterWest Management Partners, VII, LLC | 06/21/2004 | |
Stephen Bowsher, an individual, on behalf of InterWest Management Partners VII, LLC, General Partner | 06/21/2004 | |
Karen A. Wilson, Power-of-Attorney for Harvey B. Cash, an individual, on behalf of InterWest Management Partners VII, LLC, General Partner | 06/21/2004 | |
Philip T. Gianos, an individual, on behalf of InterWest Management Partners VII, LLC, General Partner | 06/21/2004 | |
Karen A. Wilson, Power-of-Attorney for W. Scott Hedrick, an individual, on behalf of InterWest Management Partners VII, LLC, General Partner | 06/21/2004 | |
Karen A. Wilson, Power-of-Attorney for Stephen W. Holmes, an individual, on behalf of InterWest Management Partners VII, LLC, General Partner | 06/21/2004 | |
Gilbert Kilman, an individual, on behalf of InterWest Management Partners VII, LLC, General Partner | 06/21/2004 | |
Arnold L. Oronsky, an individual, on behalf of InterWest Management Partners VII, LLC, General Partner | 06/21/2004 | |
** 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 4 (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. |