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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Common Stock Warrant (right to buy) | $ 0.3361 | 05/10/2012 | P | 6,241,119 | 05/10/2012 | 05/10/2018 | Common Stock | 6,241,119 | (1) | 6,241,119 | I | Sanderling Venture Partners VI Co-Investment Fund, L.P. | |||
Common Stock Warrant (right to buy) | $ 0.3361 | 05/10/2012 | P | 265,062 | 05/10/2012 | 05/10/2018 | Common Stock | 265,062 | (2) | 265,062 | I | Sanderling Ventures Management VI | |||
Common Stock Warrant (right to buy) | $ 0.3361 | 05/07/2012(3) | J(4) | 1,498,482 | 05/07/2012 | 05/07/2017 | Common Stock | 1,498,482 | $ 0 | 1,498,482 | I | Sanderling Venture Partners VI Co-Investment Fund L.P. | |||
Common Stock Warrant (right to buy) | $ 0.3361 | 05/07/2012(3) | J(4) | 29,000 | 05/07/2012 | 05/07/2017 | Common Stock | 29,000 | $ 0 | 29,000 | I | Sanderling VI Beteiligungs GmbH & Co. KG | |||
Common Stock Warrant (right to buy) | $ 0.3361 | 05/07/2012(3) | J(4) | 34,553 | 05/07/2012 | 05/07/2017 | Common Stock | 34,553 | $ 0 | 34,553 | I | Sanderling VI Limited Partnership |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MIDDLETON FRED A 400 SOUTH EL CAMINO REAL SUITE 1200 SAN MATEO, CA 94402-1708 |
X |
/s/ Karen W. Duros, Attorney-in-Fact | 05/14/2012 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The reported securities are included within 6,241,119 Stereotaxis units purchased by the reporting person for 0.4611 per unit. Each unit consists of one share of common stock, and one warrant to purchase one share of common stock. |
(2) | The reported securities are included within 265,062 Stereotaxis units purchased by the reporting person for 0.4611 per unit. Each unit consists of one share of common stock, and one warrant to purchase one share of common stock. |
(3) | The warrant was issued dated May 7, 2012, subject to closing conditions, which were satisfied on May 11, 2012. Beneficial ownership was acquired on May 11, 2012, upon satisfaction of closing conditions. |
(4) | Warrant received in connection with the extension of an unsecured loan commitment between Sanderling Venture Partners VI Co-Investment Fund, L.P., Sanderling VI Beteiligungs GmbH & Co. KG, Sanderling VI Limited Partnership, respectively, and Issuer. |