0001437749-14-017899.txt : 20141002 0001437749-14-017899.hdr.sgml : 20141002 20141002192824 ACCESSION NUMBER: 0001437749-14-017899 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140923 FILED AS OF DATE: 20141002 DATE AS OF CHANGE: 20141002 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VIVEVE MEDICAL, INC. CENTRAL INDEX KEY: 0000879682 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 043153858 STATE OF INCORPORATION: B0 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 150 COMMERCIAL STREET CITY: SUNNYVALE STATE: CA ZIP: 94086 BUSINESS PHONE: 4085301900 MAIL ADDRESS: STREET 1: 150 COMMERCIAL STREET CITY: SUNNYVALE STATE: CA ZIP: 94086 FORMER COMPANY: FORMER CONFORMED NAME: PLC SYSTEMS INC DATE OF NAME CHANGE: 19930328 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GBS Bioventures III A/C CENTRAL INDEX KEY: 0001542844 STATE OF INCORPORATION: C3 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11388 FILM NUMBER: 141138064 BUSINESS ADDRESS: STREET 1: LEVEL 5 STREET 2: 71 COLLINS ST CITY: MELBOURNE STATE: C3 ZIP: VIC 3000 BUSINESS PHONE: 61386509921 MAIL ADDRESS: STREET 1: LEVEL 5 STREET 2: 71 COLLINS ST CITY: MELBOURNE STATE: C3 ZIP: VIC 3000 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GBS Venture Partners Pty, Ltd CENTRAL INDEX KEY: 0001542845 STATE OF INCORPORATION: C3 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11388 FILM NUMBER: 141138065 BUSINESS ADDRESS: STREET 1: LEVEL 5 STREET 2: 71 COLLINS ST CITY: MELBOURNE STATE: C3 ZIP: VIC 3000 BUSINESS PHONE: 61386509921 MAIL ADDRESS: STREET 1: LEVEL 5 STREET 2: 71 COLLINS ST CITY: MELBOURNE STATE: C3 ZIP: VIC 3000 3 1 rdgdoc.xml FORM 3 X0206 3 2014-09-23 0 0000879682 VIVEVE MEDICAL, INC. PLCSD 0001542845 GBS Venture Partners Pty, Ltd LEVEL 5 71 COLLINS STREET MELBOURNE C3 VIC 3000 AUSTRALIA 1 0001542844 GBS Bioventures III A/C LEVEL 5 71 COLLINS STREET MELBOURNE C3 VIC 3000 AUSTRALIA 1 Common Stock 2650935 I See footnotes Common Stock 2650935 D Directly beneficially owned by GBS BioVentures III. GBS Venture Partners Limited is trustee for GBS BioVentures III and may be deemed to have sole voting and investment power over the shares beneficially owned by GBS BioVentures III. GBS Venture Partners Limited disclaims beneficial ownership of such shares except to the extent of its pecuniary interest therein. Amount includes (a) 1,707,339 shares issued pursuant to the merger by and among the Issuer, Viveve, Inc. and PLC Systems Acquisition Corporation, completed on 9/23/2014 (the "Closing"), and (b) 943,596 shares of common stock issued upon the automatic exercise of a warrant at the Closing. /s/ Brigitte Smith as Managing Partner of GBS Venture Partners Limited 2014-10-02 /s/ Brigitte Smith as Managing Partner of GBS Venture Partners Limited, a Trustee of GBS BioVentures III 2014-10-02