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Filing Details

Accession Number:: 0001209191-15-034055
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2015-04-14 17:26:47
Reporting Period:: 2015-04-14

Filing Date:: 2015-04-14
Accepted Time:: 2015-04-14 17:26:47
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1348911	Carbylan Therapeutics Inc.	CBYL	Pharmaceutical Preparations (2834)	000000000

Insiders

Cik	Name	Reported Address	Director	Officer	Large Shareholder	Other
1207831	T Philip Gianos	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1207833	L Arnold Oronsky	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1276600	Khaled Nasr	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1293171	H Gilbert Kliman	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1293923	Stephen W Holmes	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1333063	A Bruce Cleveland	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1381839	A Douglas Pepper	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1381980	S Nina Kjellson	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1398927	Interwest Management Partners Ix, Llc	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No
1398928	Interwest Partners Ix, Lp	C/O Interwest Partners 2710 Sand Hill Road, Suite 200 Menlo Park CA 94025	No	No	Yes	No

Reported Non-Derivative Transactions

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Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2015-04-14	831,531	$0.00	831,531	No	4	C	Indirect	See Footnote
Common Stock	Acquisiton	2015-04-14	2,145,351	$0.00	2,976,882	No	4	C	Indirect	See Footnote
Common Stock	Acquisiton	2015-04-14	466,357	$0.00	3,443,239	No	4	C	Indirect	See Footnote
Common Stock	Acquisiton	2015-04-14	365,957	$0.00	3,809,196	No	4	C	Indirect	See Footnote
Common Stock	Acquisiton	2015-04-14	810,000	$5.00	4,619,196	No	4	P	Indirect	See Footnote

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	See Footnote
No	4	C	Indirect	See Footnote
No	4	C	Indirect	See Footnote
No	4	C	Indirect	See Footnote
No	4	P	Indirect	See Footnote

Reported Derivative Transactions

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series A Convertible Preferred Stock	Disposition	2015-04-14	831,531	$0.00	831,531	$0.00
Common Stock	Series B Convertible Preferred Stock	Disposition	2015-04-14	2,145,351	$0.00	2,145,351	$0.00
Common Stock	Convertible Promissory Note	Disposition	2015-04-14	466,357	$0.00	466,357	$0.00
Common Stock	Convertible Promissory Note	Disposition	2015-04-14	365,957	$0.00	365,957	$0.00

Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect

Footnotes

Upon the closing of the Issuer's initial public offering, each share of Series A Convertible Preferred Stock and Series B Convertible Preferred Stock automatically converted into Common Stock on a one for one basis without payment or further consideration, and has no expiration date.
The shares are held by InterWest Partners IX, L.P. ("IW9"). InterWest Management Partners IX, LLC ("IMP9"), the general partner of IW9, has sole voting and investment control over the shares held by IW9. Philip T. Gianos, W. Stephen Holmes, Gilbert H. Kliman and Arnold Oronsky are the managing directors of IMP9. Bruce A. Cleveland, Nina Kjellson, Khaled A. Nasr and Douglas A. Pepper are the venture members of IMP9. Each of the managing directors and venture members share voting and investment control with respect to the share held by IW9 and disclaims beneficial ownership of the shares reported herein, except to the extent of his respective pecuniary interest therein.
The Convertible Promissory Note is convertible into the number of shares of the Issuer's Common Stock equal to the quotient obtained by dividing the entire principal amount and 184 days of accrued interest on the Convertible Promissory Note by 80% of the initial public offering price of $5.00 per share of the Issuer's Common Stock, automatically upon the closing of the Issuer's initial public offering, and has no expiration date.
The Convertible Promissory Note is convertible into the number of shares of the Issuer's Common Stock equal to the quotient obtained by dividing the entire principal amount and 41 days of accrued interest on the Convertible Promissory Note by 80% of the initial public offering price of $5.00 per share of the Issuer's Common Stock, automatically upon the closing of the Issuer's initial public offering, and has no expiration date.