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) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series A Convertible Preferred Stock
|
12/25/2008 |
Â
(2)
|
Common Stock
|
2,400,000
(2)
|
$
0
|
D
|
Â
|
Options to purchase Common Stock, par value $0.001 per share
|
02/01/2012 |
02/01/2017 |
Common Stock
|
1,300,000
(3)
|
$
0.04
|
D
|
Â
|
* |
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) |
Represents 49,847,564 shares of the Issuer's common stock held directly by the Reporting Person and 125,139 shares of common stock held by members of the Reporting Person's immediate family. |
(2) |
Represents shares of the Issuer's preferred stock issued to the Reporting Person in connection with a Settlement Agreement, dated September 25, 2008, between the Reporting Person and the Issuer. The shares are convertible into the Issuer's common stock on a basis of one common share for each preferred share held. |
(3) |
Represents a vested 5-year options to purchase shares of the Issuer's common stock at $0.04 per share, issued to the Reporting Person under the Issuer's 2011 Equity Incentive Plan, for which options to purchase 520,000 shares vested on February 1, 2012, the grant date, and options to purchase an additional 780,000 shares will vest in three equal portions on each of December 31, 2012, 2013 and 2014. |