0001104659-16-125355.txt : 20160603 0001104659-16-125355.hdr.sgml : 20160603 20160603143123 ACCESSION NUMBER: 0001104659-16-125355 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160601 FILED AS OF DATE: 20160603 DATE AS OF CHANGE: 20160603 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TESARO, Inc. CENTRAL INDEX KEY: 0001491576 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 272249687 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1000 WINTER STREET, SUITE 3300 CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: (339) 970-0900 MAIL ADDRESS: STREET 1: 1000 WINTER STREET, SUITE 3300 CITY: WALTHAM STATE: MA ZIP: 02451 FORMER COMPANY: FORMER CONFORMED NAME: Tesaro, Inc. DATE OF NAME CHANGE: 20100510 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SEIDENBERG BETH C CENTRAL INDEX KEY: 0001184592 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35587 FILM NUMBER: 161695178 4 1 a4.xml 4 X0306 4 2016-06-01 0 0001491576 TESARO, Inc. TSRO 0001184592 SEIDENBERG BETH C C/O TESARO, INC. 1000 WINTER STREET, SUITE 3300 WALTHAM MA 02451 1 0 0 0 Common Stock 2016-06-01 4 A 0 1269 0 A 21657 D Common Stock 2686268 I See footnotes Common Stock 227255 I See footnotes Common Stock 205 I By Michael J. Seidenberg Irrevocable Trust Common Stock 205 I By Samuel B. Seidenberg Irrevocable Trust Director Nonqualified Stock Option (right to buy) 47.27 2016-06-01 4 A 0 12000 0 A 2026-06-01 Common Stock 12000 12000 D The Reporting Person has elected to receive common stock in lieu of cash for board retainers and fees otherwise payable in cash, and has elected to defer delivery of that common stock until the date that she separates from service on the Issuer's board of directors. The shares are held directly by Kleiner Perkins Caufield & Byers XIV, LLC ("KPCB XIV"). The managing member of KPCB XIV is KPCB XIV Associates, LLC ("KPCB XIV Associates"), of which the Reporting Person is a member. The voting and dispositive control over the shares is shared by the members of KPCB XIV Associates. The shares are held for convenience in the name of "KPCB Holdings, Inc. as nominee." The Reporting Person disclaims beneficial ownership over all Issuer shares held for convenience in the name of "KPCB Holdings, Inc. as nominee," except to the extent of her pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these shares for the purposes of Section 16 or for any other purpose. The shares are held directly by KPCB XIV Founders Fund, LLC ("KPCB XIV Founders"). The managing member of KPCB XIV Founders is KPCB XIV Associates, of which the Reporting Person is a member. The voting and dispositive control over the shares is shared by the members of KPCB XIV Associates. The shares are held for convenience in the name of "KPCB Holdings, Inc. as nominee." The Reporting Person and her spouse are co-trustees of the trust and their son is beneficiary of the trust. The Reporting Person disclaims beneficial ownership of these shares, except to the extent of her pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose. The option vests on the earlier of the one-year anniversary of the date of grant and the next annual meeting of the Issuer's stockholders, subject to the Reporting Person's continued service on the Issuer's board of directors. /s/ Paul Vronsky, Attorney-in-Fact 2016-06-03