SEC FORM
4
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
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OMB APPROVAL |
OMB Number: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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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*
ONE EMBARCADERO CENTER, 37TH FLOOR |
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(Street)
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2. Issuer Name and Ticker or Trading Symbol
CHIMERIX INC
[ CMRX ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
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Officer (give title below) |
X |
Other (specify below) |
Stockholder
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3. Date of Earliest Transaction
(Month/Day/Year) 04/16/2013
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
04/16/2013 |
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C |
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826,474 |
A |
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826,474 |
I
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See Footnote
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Common Stock |
04/16/2013 |
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C |
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688,729 |
A |
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1,515,203 |
I
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See Footnote
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Common Stock |
04/16/2013 |
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C |
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550,982 |
A |
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2,161,829
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I
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See Footnote
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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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 |
Series D Preferred Stock |
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04/16/2012 |
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C |
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2,933,986 |
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Common Stock |
826,474 |
$0.00
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0 |
I
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See Footnote
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Series E Preferred Stock |
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04/16/2012 |
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C |
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2,444,990 |
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Common Stock |
688,729 |
$0.00
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0 |
I
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See Footnote
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Series F Preferred Stock |
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04/16/2012 |
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C |
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1,955,991 |
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Common Stock |
550,982 |
$0.00
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0 |
I
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See Footnote
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1. Name and Address of Reporting Person*
ONE EMBARCADERO CENTER, 37TH FLOOR |
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(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADERO CENTER, 37TH FLOOR |
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(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADERO CENTER, 37TH FLOOR |
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(Street)
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Explanation of Responses: |
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See Signatures Included in Exhibit 99.2 |
04/16/2013 |
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** 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. |
Exhibit 99.1
(2) The shares of Common Stock issuable
upon conversion of the Preferred Stock are held as follows: 1,892,453 shares of common stock held by Alta Biopharma Partners III,
L.P., 127,095 shares of common stock held by Alta Biopharma Partners III GmbH & Co. Beteiligungs KG and 46,637 shares of common
stock held by Alta Embarcadero Biopharma Partners III, LLC (collectively, the Alta Shares). Alta Partners III, Inc. provides investment
advisory services to Alta Biopharma Partners III, L.P., Alta Biopharma Partners III GmbH & Co. Beteiligungs KG and Alta Embarcadero
Biopharma Partners III, LLC (collectively, the Alta Funds). The directors of Alta Biopharma Management III, LLC, which is a general
partner of Alta Biopharma Partners III, L.P., the managing limited partner of Alta Biopharma Partners III GmbH & Co. Beteiligungs
KG, and the manager of Alta Embarcadero Biopharma Partners III, LLC, exercise sole dispositive and voting power over the securities
owned by the Alta Funds. Farah Champsi, one of the Issuer’s directors, Edward Penhoet and Edward Hurwitz, are directors of
Alta Biopharma Management III, LLC and managers of Alta Embarcadero Biopharma Partners III, LLC. These individuals may be deemed
to share dispositive and voting power over the securities held by the Alta Funds. Each of these individuals disclaims beneficial
ownership of such securities except to the extent of his or her pecuniary interest therein.
Exhibit 99.2
Signature of Reporting Persons:
This statement on Form 4 is filed by Alta
Biopharma Partners III, L.P., Alta Biopharma Partners III GmbH & Co. Beteiligungs KG and Alta Embarcadero Biopharma Partners
III, LLC. The principal business address of each of the reporting persons is c/o Alta Biopharma Partners III, L.P., One Embarcadero
Center, 37th Floor, San Francisco, CA 94111. The reporting entities disclaim beneficial ownership of the securities
listed herein except to the extent of their pecuniary interest therein.
Alta Biopharma Partners III, L.P. |
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By: |
Alta Biopharma Management III, LLC |
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By:
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/s/ Hilary Strain |
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Name: |
Hilary Strain |
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Title: |
Chief Financial Officer |
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Alta Biopharma Partners III GmbH & Co. Beteiligungs KG |
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By: |
Alta Biopharma Management III, LLC |
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By:
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/s/ Hilary Strain |
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Name: |
Hilary Strain |
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Title: |
Chief Financial Officer |
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Alta Embarcadero Biopharma Partners III, LLC |
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By: |
/s/ Hilary Strain |
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Name: |
Hilary Strain |
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Title: |
Chief Financial Officer |
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