SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
TECHNE CORP /MN/

(Last) (First) (Middle)
614 MCKINLEY PLACE NE

(Street)
MINNEAPOLIS MN 55413

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ChemoCentryx, Inc. [ CCXI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
02/13/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/13/2012 C 4,713,566 A (1) 4,713,566 D
Common Stock 02/13/2012 C 1,021,490 A (2) 5,735,056 D
Common Stock 02/13/2012 P 500,000 A $10 6,235,056 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Preferred Stock (1) 02/13/2012 C 5,000,000 (1) (1) Common Stock 2,500,000 (1) 0 D
Series B Preferred Stock (1) 02/13/2012 C 1,946,836 (1) (1) Common Stock 973,418 (1) 0 D
Series C Preferred Stock (1) 02/13/2012 C 1,223,148 (1) (1) Common Stock 611,574 (1) 0 D
Series D Preferred Stock (1) 02/13/2012 C 1,257,149 (1) (1) Common Stock 628,574 (1) 0 D
Convertible Promissory Note (2) 02/13/2012 C $10,214,900 (2) (2) Common Stock 1,021,490 (2) 0 D
Warrant $20 02/13/2012 A 150,000 02/13/2012 02/12/2022 Common Stock 150,000 $0 150,000 D
Explanation of Responses:
1. The Issuer's Preferred Stock, which had no expiration date, automatically converted to Common Stock at the closing of the Issuer's initial public offering ("IPO") on February 13, 2012 at a conversion ratio of one share of Common Stock for every two shares of Preferred Stock rounded down to the next whole number, for no additional consideration.
2. The principal amount of the Convertible Promissory Note, plus accrued interest, automatically converted upon the closing of the IPO at a conversion price of $10.00 per share.
Thomas E Oland, CEO 02/14/2012
** 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 4 (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.