FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/28/2012 |
3. Issuer Name and Ticker or Trading Symbol
Millennial Media Inc. [ MM ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A-1 Convertible Preferred Stock | (1) | (1) | Common Stock | 2,926,830 | (1) | I | By Funds(2)(3) |
Series A-2 Convertible Preferred Stock | (1) | (1) | Common Stock | 4,724,110 | (1) | I | By Funds(2)(4) |
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 2,537,370 | (1) | I | By Funds(2)(5) |
Series C Convertible Preferred Stock | (1) | (1) | Common Stock | 896,636 | (1) | I | By Funds(2)(6) |
Series D Convertible Preferred Stock | (1) | (1) | Common Stock | 2,415,285 | (1) | I | By Funds(2)(7) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. Each share of convertible preferred stock is convertible, at anytime, at the holder's election, into common stock on a one-for-one basis. In addition, effective upon the closing of the issuer's initial public offering of its common stock, each share of convertible preferred stock will automatically convert into one share of common stock. The convertible preferred stock has no expiration date. |
2. Deer VI & Co LLC ("Deer VI") is the general partner of Bessemer Venture Partners VI L.P. ("BVP VI"), Bessemer Venture Partners Co-Investment L.P. ("BVP Co-Investment") and Bessemer Venture Partners VI Institutional L.P. ("BVP Institutional", and together with BVP VI and BVP Co-Investment, the "Funds"). The Funds, together with Deer VI, are the "Bessemer Entities." Deer VI disclaims beneficial ownership of the securities owned directly by the Funds, and this report shall not be deemed as admission that Deer VI is the beneficial owner of such securities, except to the extent of its pecuniary interest therein, if any, by virtue of its general partner interests in the Funds. Robert Goodman, an executive manager of Deer VI, serves as the representative of the Bessemer Entities on the issuer's board of directors. |
3. BVP VI owns 2,162,195 shares. BVP Co-Investment owns 728,050 shares. BVP Institutional owns 36,585 shares. |
4. BVP VI owns 3,489,935 shares. BVP Co-Investment owns 1,175,125 shares. BVP Institutional owns 59,050 shares. |
5. BVP VI owns 1,874,480 shares. BVP Co-Investment owns 631,175 shares. BVP Institutional owns 31,715 shares. |
6. BVP VI owns 672,477 shares. BVP Co-Investment owns 224,159 shares. |
7. BVP VI owns 1,811,464 shares. BVP Co-Investment owns 603,821 shares. |
Remarks: |
/s/ J. Edmund Colloton, Executive Manager of Deer VI & Co. LLC | 03/28/2012 | |
/s/ J. Edmund Colloton, as Executive Manager of Deer VI & Co. LLC, the General Partner of Bessemer Venture Partners Co-Investment L.P. | 03/28/2012 | |
/s/ J. Edmund Colloton, as Executive Manager of Deer VI & Co. LLC, the General Partner of Bessemer Venture Partners VI Institutional L.P. | 03/28/2012 | |
/s/ J. Edmund Colloton, as Executive Manager of Deer VI & Co. LLC, the General Partner of Bessemer Venture Partners VI L.P. | 03/28/2012 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |