X0202 3 2004-10-06 0 0001163848 INTRALASE CORP ILSE 0001293171 Kliman Gilbert H C/O INTERWEST MANAGEMENT PARTNERS VIII LLC 2710 SAND HILL ROAD, SECOND FLOOR MENLO PARK CA 94025 1 0 1 0 Series E Preferred Stock Common Stock 1996823 I By InterWest Partners VIII, L.P. Series E Preferred Stock Common Stock 57170 I By InterWest Investors Q VIII, L.P. Series E Preferred Stock Common Stock 17400 I By InterWest Investors VIII, L.P. Series F Preferred Stock Common Stock 664262 I By InterWest Partners VIII, L.P. Series F Preferred Stock Common Stock 19004 I By InterWest Investors Q VIII, L.P. Series F Preferred Stock Common Stock 5302 I By InterWest Investors VIII, L.P. Series G Preferred Stock Common Stock 604944 I By InterWest Partners VIII, L.P. Series G Preferred Stock Common Stock 17317 I By InterWest Investors Q VIII, L.P. Series G Preferred Stock Common Stock 5155 I By InterWest Investors VIII, L.P. The reporting person disclaims ownership of the shares reported, except to the extent of his pecuniary interest therein. The issuer's Series E Preferred Stock will automatically convert into Common Stock on a 1-for-0.882067 basis upon the closing of the issuer's initial public offering. The issuer's Series F Preferred Stock will automatically convert into Common Stock on a 1-for-0.721528 basis upon the closing of the issuer's initial public offering. The issuer's Series G Preferred Stock will automatically convert into Common Stock on a 1-for-0.721528 basis upon the closing of the issuer's initial public offering. The shares owned by InterWest Partners VIII, L.P. (IP8). The general partner of IP8 is InterWest Management Partners VIII, LLC (IMP8). The Reporting Person is a managing director of IMP8. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The shares owned by InterWest Investors Q VIII, L.P. (IIQ8). The general partner of IIQ8 is IMP8. The Reporting Person is a managing director of IMP8. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The shares owned by InterWest Investors VIII, L.P. (II8). The general partner of II8 is IMP8. The Reporting Person is a managing director of IMP8. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. Immediately. /s/ Gilbert H. Kliman 2004-10-06