0000904454-11-000631.txt : 20111121
0000904454-11-000631.hdr.sgml : 20111121
20111121210407
ACCESSION NUMBER: 0000904454-11-000631
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111121
FILED AS OF DATE: 20111121
DATE AS OF CHANGE: 20111121
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DP VII ASSOCIATES LP
CENTRAL INDEX KEY: 0001372932
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35347
FILM NUMBER: 111220253
BUSINESS ADDRESS:
STREET 1: ONE PALMER SQ
STREET 2: STE 515
CITY: PRINCETON
STATE: NJ
ZIP: 08542
MAIL ADDRESS:
STREET 1: ONE PALMER SQ
STREET 2: STE 515
CITY: PRINCETON
STATE: NJ
ZIP: 08542
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Clovis Oncology, Inc.
CENTRAL INDEX KEY: 0001466301
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 900475355
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2525 28TH STREET
STREET 2: SUITE 100
CITY: BOULDER
STATE: CO
ZIP: 80301
BUSINESS PHONE: (303) 625-5000
MAIL ADDRESS:
STREET 1: 2525 28TH STREET
STREET 2: SUITE 100
CITY: BOULDER
STATE: CO
ZIP: 80301
4
1
edgar.xml
PRIMARY DOCUMENT
X0304
4
2011-11-21
0001466301
Clovis Oncology, Inc.
CLVS
0001372932
DP VII ASSOCIATES LP
C/O DOMAIN ASSOCIATES, LLC
ONE PALMER SQUARE
PRINCETON
NJ
08542
0
0
1
0
Common Stock
2011-11-21
4
C
0
6979
A
6979
D
Common Stiock
2011-11-21
4
C
0
6979
A
13958
D
Common Stock
2011-11-21
4
C
0
15106
A
29064
D
Common Stock
2011-11-21
4
C
0
6324
A
35388
D
Common Stock
2011-11-21
4
P
0
15625
13.00
A
51013
D
Series A-1 Preferred Stock
2011-11-21
4
C
0
20240
0
D
Common Stock
6979
0
D
Series A-2 Preferred Stock
2011-11-21
4
C
0
20240
0
D
Common Stock
6979
0
D
Series B Preferred Stok
2011-11-21
4
C
0
43809
0
D
Common Stock
15106
0
D
Convertible Promissory Note
2011-11-21
4
C
0
80229.00
0
D
Common Stock
6324
0
D
All outstanding shares of the Issuer's preferred stock were automatically converted into Common Stock upon the closing of the Issuer's iniital public offering (the "IPO"), for no additional consideration.
The Convertible Promissory Note plus interest accrued thereon through the closing of the IPO, automatically converted into Common Stock upon the closing of the IPO, based on the IPO price of $13.00 per share.
/s/Kathleen K. Schoemaker, Managing Member of One Palmer Square Associates VII, LLC, General Partner of DP VII Associates, L.P.
2011-11-21