0000899243-16-026908.txt : 20160811 0000899243-16-026908.hdr.sgml : 20160811 20160811200904 ACCESSION NUMBER: 0000899243-16-026908 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160811 FILED AS OF DATE: 20160811 DATE AS OF CHANGE: 20160811 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AIRGAIN INC CENTRAL INDEX KEY: 0001272842 STANDARD INDUSTRIAL CLASSIFICATION: RADIO & TV BROADCASTING & COMMUNICATIONS EQUIPMENT [3663] IRS NUMBER: 200281763 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3611 VALLEY CENTRE DRIVE STREET 2: SUITE 150 CITY: SAN DIEGO STATE: CA ZIP: 92130 BUSINESS PHONE: (760) 579-0200 MAIL ADDRESS: STREET 1: 3611 VALLEY CENTRE DRIVE STREET 2: SUITE 150 CITY: SAN DIEGO STATE: CA ZIP: 92130 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Toscanini Arthur M. CENTRAL INDEX KEY: 0001681317 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37851 FILM NUMBER: 161825965 MAIL ADDRESS: STREET 1: C/O AIRGAIN, INC. STREET 2: 3611 VALLEY CENTRE DRIVE, SUITE 150 CITY: SAN DIEGO STATE: CA ZIP: 92130 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2016-08-11 0 0001272842 AIRGAIN INC AIRG 0001681317 Toscanini Arthur M. C/O AIRGAIN, INC. 3611 VALLEY CENTRE DRIVE, SUITE 150 SAN DIEGO CA 92130 1 0 0 0 Common Stock 2930 D Common Stock 166358 I See Footnote Series A Preferred Stock Common Stock 27826 I See Footnote Series B Preferred Stock Common Stock 82416 I See Footnote Series C Preferred Stock Common Stock 39697 I See Footnote Series D Preferred Stock Common Stock 25537 D Series D Preferred Stock Common Stock 12309 I See Footnote Series E Preferred Stock Common Stock 9360 D Series F Preferred Stock Common Stock 3846 D Series G Preferred Stock Common Stock 8322 D Stock Option (Right to Buy) 2.20 2017-01-24 Common Stock 2000 D Stock Option (Right to Buy) 2.20 2017-12-10 Common Stock 2000 D Stock Option (Right to Buy) 2.60 2019-03-17 Common Stock 2000 D Stock Option (Right to Buy) 2.60 2019-12-03 Common Stock 2000 D Stock Option (Right to Buy) 2.60 2021-01-18 Common Stock 2000 D Stock Option (Right to Buy) 2.30 2023-06-12 Common Stock 4000 D Stock Option (Right to Buy) 3.10 2024-05-12 Common Stock 2000 D Stock Option (Right to Buy) 1.60 2025-06-11 Common Stock 30347 D Stock Option (Right to Buy) 1.90 2016-05-24 Common Stock 7832 D Dividend Right Common Stock 40075 D Dividend Right Common Stock 33972 I See Footnote Represents shares of common stock held by Gen 3 Partners, Inc. ("Gen 3 Partners"). Mr. Toscanini may be deemed to share beneficial ownership of the shares held by Gen 3 Partners in his capacity as a director of Gen 3 Partners. Mr. Toscanini disclaims such beneficial ownership extent to the extent of his pecuniary interest therein. The preferred stock is convertible at any time, at the holder's election and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering. The option is fully vested. The dividend rights are payable in cash or shares of common stock at the Issuer's election immediately upon the closing of the Issuer's initial public offering. /s/ Arthur M. Toscanini 2016-08-11