0001209191-14-046570.txt : 20140709
0001209191-14-046570.hdr.sgml : 20140709
20140709173740
ACCESSION NUMBER: 0001209191-14-046570
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140708
FILED AS OF DATE: 20140709
DATE AS OF CHANGE: 20140709
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: GLOBEIMMUNE INC
CENTRAL INDEX KEY: 0001245104
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 841353925
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1450 INFINITE DRIVE
CITY: LOUISVILLE
STATE: CO
ZIP: 80027
BUSINESS PHONE: 3036252744
MAIL ADDRESS:
STREET 1: 1450 INFINITE DRIVE
CITY: LOUISVILLE
STATE: CO
ZIP: 80027
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MITCHELL DANIEL J
CENTRAL INDEX KEY: 0001113661
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35642
FILM NUMBER: 14967910
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2014-07-08
0
0001245104
GLOBEIMMUNE INC
GBIM
0001113661
MITCHELL DANIEL J
C/O SEQUEL LIMITED PARTNERSHIP III
4430 ARAPAHOE AVENUE, SUITE 220
BOULDER
CO
80303
1
0
0
0
Common Stock
2014-07-08
4
C
0
6961
0.00
A
6961
I
By Sequel Entrepreneurs Fund III, LP
Common Stock
2014-07-08
4
C
0
250645
0.00
A
250645
I
By Sequel Limited Partnership III
Common Stock
2014-07-08
4
P
0
75000
10.00
A
325645
I
By Sequel Limited Partnership III
Common Stock
2014-07-08
4
P
0
10000
10.00
A
10000
D
Series A Convertible Preferred Stock
2014-07-08
4
C
0
36557
0.00
D
Common Stock
1162
0
I
By Sequel Entrepreneurs Fund III, LP
Series A Convertible Preferred Stock
2014-07-08
4
C
0
1315441
0.00
D
Common Stock
41904
0
I
By Sequel Limited Partnership III
Series B Convertible Preferred Stock
2014-07-08
4
C
0
84879
0.00
D
Common Stock
2704
0
I
By Sequel Entrepreneurs Fund III, LP
Series B Convertible Preferred Stock
2014-07-08
4
C
0
3054134
0.00
D
Common Stock
97296
0
I
By Sequel Limited Partnership III
Series C Convertible Preferred Stock
2014-07-08
4
C
0
75318
0.00
D
Common Stock
2398
0
I
By Sequel Entrepreneurs Fund III, LP
Series C Convertible Preferred Stock
2014-07-08
4
C
0
2710122
0.00
D
Common Stock
86335
0
I
By Sequel Limited Partnership III
Series E Convertible Preferred Stock
2014-07-08
4
C
0
21905
0.00
D
Common Stock
697
0
I
By Sequel Entrepreneurs Fund III, LP
Series E Convertible Preferred Stock
2014-07-08
4
C
0
788205
0.00
D
Common Stock
25110
0
I
By Sequel Limited Partnership III
Warrant to Purchase Series B Preferred Stock (right to buy)
2014-07-08
4
C
0
2334
1.338
D
Common Stock
2334
0
I
By Sequel Entrepreneurs Fund III, LP
Warrant to Purchase Series B Preferred Stock (right to buy)
2014-07-08
4
C
0
83988
1.338
D
Common Stock
83988
0
I
By Sequel Limited Partnership III
Warrant to Purchase Series C Preferred Stock (right to buy)
2014-07-08
4
C
0
1860
1.445
D
Common Stock
1860
0
I
By Sequel Entrepreneurs Fund III, LP
Warrant to Purchase Series C Preferred Stock (right to buy)
2014-07-08
4
C
0
66955
1.445
D
Common Stock
66955
0
I
By Sequel Limited Partnership III
Warrant to Purchase Common Stock (right to buy)
42.00
2014-07-08
4
C
0
74
0.00
A
Common Stock
74
74
I
By Sequel Entrepreneurs Fund III, LP
Warrant to Purchase Common Stock (right to buy)
42.00
2014-07-08
4
C
0
2675
0.00
A
Common Stock
2675
2675
I
By Sequel Limited Partnership III
Warrant to Purchase Common Stock (right to buy)
45.36
2014-07-08
4
C
0
59
0.00
A
Common Stock
59
59
I
By Sequel Entrepreneurs Fund III, LP
Warrant to Purchase Common Stock (right to buy)
45.36
2014-07-08
4
C
0
2133
0.00
A
Common Stock
2133
2133
I
By Sequel Limited Partnership III
Represents shares of common stock of the Issuer received upon conversion of shares of Series A Convertible Preferred Stock, Series B Convertible Preferred Stock, Series C Convertible Preferred Stock, and Series E Convertible Stock.
Every one share of Series A Convertible Preferred Stock, Series B Convertible Preferred Stock, Series C Convertible Preferred Stock, and Series E Convertible Stock (collectively, the "Convertible Preferred Stock") converted on a 1-for- 31.39 basis into shares of common stock of the Issuer upon the closing of the Issuer's initial public offering. The Convertible Preferred Stock of the Issuer had no expiration and was convertible at any time at the option of the holder.
Each one share of Series B Convertible Preferred Stock and Series C Convertible Preferred Stock converted on a 1-for-31.39 share basis into shares of common stock of the Issuer upon the closing of the Issuer's initial public offering. The number of shares and price per share reported herein does not reflect such conversion. The Warrant was immediately exercisable at any time at the option of the holder.
Represents warrants to purchase shares of common stock of the Issuer following the conversion of the Series B Convertible Preferred Stock and Series C Convertible Preferred Stock on a 1-for-31.39 share basis. The number of shares and price per share reported herein reflects such conversion. The Warrant is immediately exercisable at any time at the option of the holder.
The general partner of the Sequel Entrepreneurs Fund III, L.P. and Sequel Limited Partnership III (collectively, the "Sequel Funds") is Sequel Venture Partners III, L.L.C. ("SVP III"). SVP III may be deemed to indirectly beneficially own the shares owned by the Sequel Funds. The Reporting Person is a manager of SVP III and may be deemed to be the indirect beneficial owner of the shares owned by the Sequel Funds. The Reporting Person disclaims beneficial ownership of the shares held by the Sequel Funds, except to the extent of his pecuniary interest arising therein.
/s/ Matthew P. Dubofsky, Attorney-in-Fact
2014-07-09