0001104659-17-062780.txt : 20171018
0001104659-17-062780.hdr.sgml : 20171018
20171018171133
ACCESSION NUMBER: 0001104659-17-062780
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171012
FILED AS OF DATE: 20171018
DATE AS OF CHANGE: 20171018
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: TKWD Ventures LLC
CENTRAL INDEX KEY: 0001719928
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38241
FILM NUMBER: 171143131
BUSINESS ADDRESS:
STREET 1: C/O WFD VENTURES LLC
STREET 2: 1500 BROADWAY, 17TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 212-767-7500
MAIL ADDRESS:
STREET 1: C/O WFD VENTURES LLC
STREET 2: 1500 BROADWAY, 17TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WFD Ventures LLC
CENTRAL INDEX KEY: 0001720002
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38241
FILM NUMBER: 171143132
BUSINESS ADDRESS:
STREET 1: 1500 BROADWAY, 17TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 212-767-7500
MAIL ADDRESS:
STREET 1: 1500 BROADWAY, 17TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10036
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: OptiNose, Inc.
CENTRAL INDEX KEY: 0001494650
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 421771610
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1020 STONY HILL ROAD
STREET 2: SUITE 300
CITY: YARDLEY
STATE: PA
ZIP: 19067
BUSINESS PHONE: 267-364-3500
MAIL ADDRESS:
STREET 1: 1020 STONY HILL ROAD
STREET 2: SUITE 300
CITY: YARDLEY
STATE: PA
ZIP: 19067
3
1
a3.xml
3
X0206
3
2017-10-12
0
0001494650
OptiNose, Inc.
OPTN
0001720002
WFD Ventures LLC
C/O WFD VENTURES LLC
1500 BROADWAY, 17TH FLOOR
NEW YORK
NY
10036
0
0
1
0
0001719928
TKWD Ventures LLC
C/O WFD VENTURES LLC
1500 BROADWAY, 17TH FLOOR
NEW YORK
NY
10036
0
0
1
0
Series B-2 Convertible Preferred Stock
Common Stock
2077049
I
By: TKWD Ventures LLC
Series C Convertible Preferred Stock
Common Stock
118865
I
By: TKWD Ventures LLC
Series C-1 Convertible Preferred Stock
Common Stock
549971
I
By: TKWD Ventures LLC
Series C-2 Convertible Preferred Stock
Common Stock
267254
I
By: TKWD Ventures LLC
Warrant (Right to Buy)
8.16
2020-11-01
Common Stock
1488366
I
By: TKWD Ventures LLC
On October 10, 2017, the Issuer effected a 2.8879-for-1 stock split of its issued and outstanding shares of common stock. All series of Convertible Preferred Stock will automatically convert into OptiNose, Inc. common stock on a 1-to-2.8879 basis upon the closing of the initial public offering into the number of shares of common stock shown in column 3 above and have no expiration date.
The reportable securities are owned directly by TKWD Ventures LLC. WFD Ventures LLC is the general partner of TKWD Ventures LLC and may be deemed to have sole voting and investment power over the shares owned by TKWD Ventures LLC.
All warrants are currently exercisable.
Exercise price and number of warrant shares have been adjusted to reflect the Issuer's 2.8879-for-1 stock split of its issued and outstanding shares of common stock effected on October 10, 2017.
TKWD Ventures LLC, by WFD Ventures LLC, its general partner /s/ William F. Doyle, Managing Partner
2017-10-16
WFD Ventures LLC /s/ William F. Doyle, Managing Partner
2017-10-16