X0204 3 2011-11-15 0 0001466301 Clovis Oncology, Inc. CLVS 0001266567 ATWOOD BRIAN G VERSANT VENTURES 3000 SAND HILL ROAD BUILDING FOUR, SUITE 210 MENLO PARK CA 94025 1 0 1 0 Series A-1 Convertible Preferred Stock 0.00 Common Stock 295404 I See Footnote Series A-1 Convertible Preferred Stock 0.00 Common Stock 1861 I See Footnote Series A-2 Convertible Preferred Stock 0.00 Common Stock 295404 I See Footnote Series A-2 Convertible Preferred Stock 0.00 Common Stock 1861 I See Footnote Series B Convertible Preferred Stock 0.00 Common Stock 639403 I See Footnote Series B Convertible Preferred Stock 0.00 Common Stock 4027 I See Footnote Convertible Promissory Note 3396603.32 Common Stock 267755 I See Footnote Convertible Promissory Note 21396.68 Common Stock 1686 I See Footnote Common Stock Options 0.29 Common Stock 25862 I See Footnote Common Stock Options 3.08 Common Stock 6896 I See Footnote Common Stock Options 11.02 Common Stock 12413 I See Footnote Each share of Common Stock, Series A-1, Series A-2 and Series B Convertible Preferred Stock will automatically convert on a 1-for-1 basis into common stock upon the consummation of the Issuer's initial public offering. The securities are immediately convertible. The expiration date is not relevant to the conversion of these securities. The shares are held by Versant Venture Capital IV, L.P. ("Versant IV"). In their capacity as managing members of Versant Ventures IV, LLC which is the general partner of each Versant IV, Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen share voting and investment authority over the shares held by the Versant IV and may be deemed to beneficially own the shares. Each of Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen disclaim beneficial ownership of these shares except to the extent of his or her pecuniary interest therein. The shares are held by Versant Side Fund IV, L.P. ("Versant Side"). In their capacity as managing members of Versant Ventures IV, LLC which is the general partner of each Versant Side, Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen share voting and investment authority over the shares held by the Versant Side and may be deemed to beneficially own the shares. Each of Brian G. Atwood, Ross A. Jaffe, M.D., Camille D. Samuels, Kevin J. Wasserstein, Samuel D. Colella, Rebecca B. Robertson, Bradley J. Bolzon, Ph.D., William J. Link, Ph.D., Charles M. Warden, Robin L. Praeger and Kirk G. Nielsen disclaim beneficial ownership of these shares except to the extent of his or her pecuniary interest therein. The outstanding principal amount and all accrued and unpaid interest thereon will convert into shares of common stock at a price per share equal to the initial public offering price upon consummation of the Issuer's initial public offering. The shares are held by Brian G. Atwood (the "Reporting Person"). The Reporting Person is a Managing Director of Versant Ventures IV, LLC, which serves as the general partner of Versant Venture Capital IV, L.P. and Versant Side Fund IV, L.P. The Reporting Person disclaims beneficial ownership of the shares reported herein, except to the extent of its pecuniary interest therein. /s/ Brian G. Atwood 2011-11-15