-----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, RbX9p7RbZ8uj7Rol3ExXmSTuy1087s/oCKkWQuXIeiQopOv+clDKmGkkX4dI/Qzf AV2Qf6pBG7n5/LPfRL4kYQ== 0001209191-10-024397.txt : 20100429 0001209191-10-024397.hdr.sgml : 20100429 20100429193727 ACCESSION NUMBER: 0001209191-10-024397 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100427 FILED AS OF DATE: 20100429 DATE AS OF CHANGE: 20100429 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INTERSOUTH AFFILIATES V LP CENTRAL INDEX KEY: 0001110874 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34703 FILM NUMBER: 10783463 BUSINESS ADDRESS: STREET 1: 3211 SHANNON RD STREET 2: STE 610 CITY: DURHAM STATE: NC ZIP: 27707 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dougherty Dennis CENTRAL INDEX KEY: 0001416279 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34703 FILM NUMBER: 10783464 MAIL ADDRESS: STREET 1: 406 BLACKWELL STREET, SUITE 200 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mumma Mitch CENTRAL INDEX KEY: 0001416281 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34703 FILM NUMBER: 10783465 MAIL ADDRESS: STREET 1: 406 BLACKWELL STREET, SUITE 200 CITY: DURHAM STATE: NC ZIP: 27701 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ALIMERA SCIENCES INC CENTRAL INDEX KEY: 0001267602 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 6120 WINDWARD PARKWAY STREET 2: STE 290 CITY: ALPHARETTA STATE: GA ZIP: 30005 BUSINESS PHONE: 6789905740 MAIL ADDRESS: STREET 1: 6120 WINDWARD PARKWAY STREET 2: STE 290 CITY: ALPHARETTA STATE: GA ZIP: 30005 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Intersouth Partners V, L.P. CENTRAL INDEX KEY: 0001416271 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34703 FILM NUMBER: 10783467 BUSINESS ADDRESS: STREET 1: 406 BLACKWELL STREET, SUITE 200 CITY: DURHAM STATE: NC ZIP: 27701 BUSINESS PHONE: (919) 493-6640 MAIL ADDRESS: STREET 1: 406 BLACKWELL STREET, SUITE 200 CITY: DURHAM STATE: NC ZIP: 27701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Intersouth Associates V, LLC CENTRAL INDEX KEY: 0001489730 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34703 FILM NUMBER: 10783466 BUSINESS ADDRESS: STREET 1: 406 BLACKWELL STREET STREET 2: SUITE 200 CITY: DURHAM STATE: NC ZIP: 27701 BUSINESS PHONE: 919-493-6640 MAIL ADDRESS: STREET 1: 406 BLACKWELL STREET STREET 2: SUITE 200 CITY: DURHAM STATE: NC ZIP: 27701 4 1 c99921_4x0.xml MAIN DOCUMENT DESCRIPTION X0303 4 2010-04-27 0001267602 ALIMERA SCIENCES INC ALIM 0001489730 Intersouth Associates V, LLC C/O INTERSOUTH PARTNERS 406 BLACKWELL STREET, SUITE 200 DURHAM NC 27701-3984 0 0 1 1 May be part of 13(d) group. 0001416281 Mumma Mitch C/O INTERSOUTH PARTNERS 406 BLACKWELL STREET, SUITE 200 DURHAM NC 27701-3984 0 0 1 1 May be part of 13(d) group. 0001416279 Dougherty Dennis C/O INTERSOUTH PARTNERS 406 BLACKWELL STREET, SUITE 200 DURHAM NC 27701-3984 0 0 1 1 May be part of 13(d) group. 0001110874 INTERSOUTH AFFILIATES V LP C/O INTERSOUTH PARTNERS 406 BLACKWELL STREET, SUITE 200 DURHAM NC 27701-3984 0 0 1 1 May be part of 13(d) group. 0001416271 Intersouth Partners V, L.P. C/O INTERSOUTH PARTNERS 406 BLACKWELL STREET, SUITE 200 DURHAM NC 27701-3984 0 0 1 1 May be part of 13(d) group. Common Stock 2010-04-27 4 C 0 36049 A 36049 I See footnote Common Stock 2010-04-27 4 C 0 24680 A 60729 I See footnote Common Stock 2010-04-27 4 C 0 8887 A 69616 I See footnote Common Stock 2010-04-27 4 C 0 788627 A 788627 I See footnote Common Stock 2010-04-27 4 C 0 536252 A 1324879 I See footnote Common Stock 2010-04-27 4 C 0 193929 A 1518808 I See footnote Common Stock 2010-04-27 4 P 0 3974 11 A 73590 I See footnote Common Stock 2010-04-27 4 P 0 86935 11 A 1605743 I See footnote Series A Preferred Stock 2010-04-27 4 C 0 36049 D Common Stock 36049 0 I See footnote Series B Preferred Stock 2010-04-27 4 C 0 24680 D Common Stock 24680 0 I See footnote Series C-1 Preferred Stock 2010-04-27 4 C 0 8887 D Common Stock 8887 0 I See footnote Series A Preferred Stock 2010-04-27 4 C 0 788627 D Common Stock 788627 0 I See footnote Series B Preferred Stock 2010-04-27 4 C 0 536252 D Common Stock 536252 0 I See footnote Series C-1 Preferred Stock 2010-04-27 4 C 0 193929 D Common Stock 193929 0 I See footnote 34,144 shares of Series A Preferred Stock automatically converted into 36,049 shares of common stock immediately prior to the closing of the Issuer's initial public offering, for no additional consideration. The reportable securities are owned directly by Intersouth Affiliates V, L.P. ("IA V"). Intersouth Associates V, LLC ("IA V, LLC") is the general partner of IA V. IA V, LLC disclaims beneficial ownership of these securities and this report shall not be deemed an admission that IA V, LLC is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein. Each of Mitch Mumma ("Mumma") and Dennis Dougherty ("Dougherty") are the member managers of IA V, LLC. Each of Mumma and Dougherty disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interest therein. Each outstanding share of preferred stock automatically converted into 1 share of common stock immediately prior to the closing of the Issuer's initial public offering, for no additional consideration. 746,946 shares of Series A Preferred Stock automatically converted into 788,627 shares of common stock immediately prior to the closing of the Issuer's initial public offering, for no additional consideration. The reportable securities are owned directly by Intersouth Partners V, L.P. ("IP V"). IA V, LLC is the general partner of IP V. IA V, LLC disclaims beneficial ownership of these securities and this report shall not be deemed an admission that IA V, LLC is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein. Each of Mitch Mumma ("Mumma") and Dennis Dougherty ("Dougherty") are the member managers of IA V, LLC. Each of Mumma and Dougherty disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interest therein. Reflects a 3.4-for-1 reverse stock split, effective as of immediately prior to the effectiveness of the Registration Statement on Form S-1 (File No. 333-162782). Immediately. Not applicable. /s/ Mitch Mumma 2010-04-29 /s/ Dennis Dougherty 2010-04-29 /s/ Mitch Mumma, Intersouth Affiliates V, LP., By: Intersouth Associates V, LLC, Its General Partner, By: Mitch Mumma, Title: Member Manager 2010-04-29 /s/ Mitch Mumma, Intersouth Partners V, LP., By: Intersouth Associates V, LLC, Its General Partner, By: Mitch Mumma, Title: Member Manager 2010-04-29 -----END PRIVACY-ENHANCED MESSAGE-----