SEC FORM
4/A
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
|
OMB APPROVAL |
OMB Number: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
|
|
|
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*
400 SOUTH EL CAMINO REAL |
SUITE 1200 |
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
CHIMERIX INC
[ CMRX ]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
3. Date of Earliest Transaction
(Month/Day/Year) 04/16/2013
|
4. If Amendment, Date of Original Filed
(Month/Day/Year) 04/16/2013
|
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
|
2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
|
4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
|
5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
|
7. Nature of Indirect Beneficial Ownership (Instr.
4)
|
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
04/16/2013 |
|
C |
|
792,037 |
A |
|
4,255,826
|
I |
SEE FOOTNOTE
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr.
4)
|
11. Nature of Indirect Beneficial Ownership (Instr.
4)
|
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
1. Name and Address of Reporting Person*
400 SOUTH EL CAMINO REAL |
SUITE 1200 |
(Street)
|
1. Name and Address of Reporting Person*
400 SOUTH EL CAMINO REAL |
SUITE 1200 |
(Street)
|
1. Name and Address of Reporting Person*
400 SOUTH EL CAMINO REAL STE 1200 |
|
(Street)
|
1. Name and Address of Reporting Person*
400 SOUTH EL CAMINO REAL |
STE 1200 |
(Street)
|
1. Name and Address of Reporting Person*
400 SOUTH EL CAMINO REAL STE 1200 |
|
(Street)
|
1. Name and Address of Reporting Person*
400 S EL CAMINO REAL |
STE 1200 |
(Street)
|
1. Name and Address of Reporting Person*
400 SOUTH EL CAMINO REAL |
SUITE 1200 |
(Street)
|
1. Name and Address of Reporting Person*
400 S. EL CAMINO REAL |
SUITE 1200 |
(Street)
|
1. Name and Address of Reporting Person*
400 SOUTH EL CAMINO REAL STE 1200 |
|
(Street)
|
1. Name and Address of Reporting Person*
400 S. EL CAMINO REAL, SUITE 1200 |
|
(Street)
|
Explanation of Responses: |
Remarks: |
|
See Signatures Included in Exhibit 99.2 |
05/28/2013 |
|
** 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
(3) The shares of Common Stock issuable
upon conversion of the Preferred Stock are held as follows: 1,116,596 shares of common stock held by Sanderling Venture Partners
V, L.P., 273,434 shares of common stock held by Sanderling V Biomedical, L.P., 155,143 shares of common stock held by Sanderling
V Limited Partnership, 138,046 shares of common stock held by Sanderling V Beteiligungs GmbH & Co. KG, 88,963 shares of common
stock held by Sanderling V Ventures Management, 281,053 shares of common stock held by Sanderling V Biomedical Co-Investment Fund,
L.P., 463,582 shares of common stock held by Sanderling Venture Partners V Co-Investment Fund, L.P., 759,370 shares of common
stock held by Sanderling V Strategic Exit Fund, L.P. (collectively, the Sanderling V Shares), 797,346 shares of common stock held
by Sanderling Venture Partners VI Co-Investment Fund, L.P., 15,431 shares of common stock held by Sanderling VI Beteiligungs GmbH
& Co. KG, 18,384 shares of common stock held by Sanderling VI Limited Partnership, 7,543 shares of common stock held by Sanderling
Ventures Management VI (collectively, the Sanderling VI Shares) and 3,446 shares of common stock held by Middleton-McNeil Retirement
Trust. Timothy J. Wollaeger, one of the Issuer’s directors, Fred A. Middleton, Robert G. McNeil and Timothy C. Mills share
voting and investment power with respect to the Sanderling V Shares. Robert G. McNeil, Fred A. Middleton, Timothy C. Mills and
Timothy J. Wollaeger share voting and investment power with respect to the Sanderling VI Shares. Fred A. Middleton and Robert
G. McNeil share voting and investment power with respect to the shares held by the Middleton-McNeil Retirement Trust. 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 Amended Form 4 is filed
is filed by Sanderling Venture Partners V, L.P., Sanderling V Biomedical, L.P., Sanderling V Limited Partnership, Sanderling V
Beteiligungs GmbH & Co. KG, Sanderling V Ventures Management, Sanderling V Biomedical Co-Investment Fund, L.P., Sanderling
Venture Partners V Co-Investment Fund, L.P., Sanderling V Strategic Exit Fund, L.P., Sanderling Venture Partners VI Co-Investment
Fund, L.P., and Sanderling VI Beteiligungs GmbH & Co. KG. The principal business address of each of the reporting persons is
c/o Sanderling Venture Partners V, L.P., 400 South El Camino Real, Suite 1200, San Mateo, CA 94402. The reporting entities disclaim
beneficial ownership of the securities listed herein except to the extent of their pecuniary interest therein.
Sanderling Venture Partners V, L.P.
|
|
|
|
|
By: |
Middleton, McNeil & Mills Associates
V, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaege |
|
|
Managing Director |
|
|
|
|
Sanderling
V Biomedical, L.P.
|
|
|
|
By: |
Middleton, McNeil & Mills Associates
V, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Managing Director |
|
|
|
|
Sanderling
V Limited Partnership
|
|
|
|
By: |
Middleton, McNeil & Mills Associates
V, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Managing Director |
|
|
|
|
Sanderling
V Beteiligungs GmbH & Co. KG
|
|
|
|
By: |
Middleton, McNeil & Mills Associates
V, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Managing Director |
|
|
|
|
Sanderling
V Ventures Management
|
|
|
|
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Owner |
|
|
|
|
Sanderling V Biomedical Co-Investment Fund, L.P.
|
|
|
|
By: |
Middleton, McNeil & Mills Associates
V, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Managing Director |
|
|
|
|
Sanderling
Venture Partners V Co-Investment Fund, L.P.
|
|
|
|
By: |
Middleton, McNeil & Mills Associates
V, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Managing Director |
|
|
|
|
Sanderling V Strategic Exit Fund, L.P.
|
|
|
|
By: |
Middleton, McNeil & Mills Associates
V, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Managing Director |
|
|
|
|
Sanderling Venture Partners VI Co-Investment Fund, L.P.
|
|
|
|
By: |
Middleton, McNeil, Mills & Associates
VI, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Managing Director |
|
|
|
|
Sanderling VI Beteiligungs GmbH & Co. KG
|
|
|
|
By: |
Middleton, McNeil, Mills & Associates
VI, LLC |
|
|
|
|
By: |
/s/ Timothy J. Wollaeger |
|
|
Timothy J. Wollaeger |
|
|
Managing Director |
|