UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Preferred Stock | Â (2) | Â (3) | Common Stock | 33,333 (1) (5) | $ (4) | D | Â |
Stock Option (right to buy) | Â (2) | 01/12/2011 | Common Stock | 5,000 (6) | $ 0.6 | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Cohen Fred E C/O TPG VENTURES 345 CALIFORNIA STREET SUITE 2600 SAN FRANCISCO, CA 94104 |
 X |  |  |  |
/s/ Fred E. Cohen | 09/28/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | Does not include shares of Common Stock that may be issued if the conditional dividend of shares of Common Stock declared by the Issuer's Board of Directors on September 8, 2005 is distributed upon the closing of the Issuer's initial public offering (the "IPO") in the event the price per share of the Issuer's Common Stock sold in the IPO is $11.40 or greater (the "Conditional Dividend"). |
(2) | These securities are exercisable immediately. |
(3) | These securities do not have an expiration date. |
(4) | Upon consummation of the IPO, every three shares of the Series A Preferred Stock will be converted into one share of Common Stock. |
(5) | Does not include 1,014,492 shares of Series D Preferred Stock and 821,513 shares of Series E Preferred Stock held by funds managed by Tarrant Advisors, Inc., with which Mr. Cohen is affiliated. |
(6) | Does not include additional shares of Common Stock underlying the option if the Conditional Dividend is distributed upon consummation of the IPO. |