Filing Details
- Accession Number:
- 0001192482-15-000195
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2015-05-13 16:31:47
- Reporting Period:
- 2015-05-12
- Filing Date:
- 2015-05-13
- Accepted Time:
- 2015-05-13 16:31:47
- SEC Url:
- Form 4 Filing
Issuer
| Cik | Name | Symbol | Sector (SIC) | IRS No |
|---|---|---|---|---|
| 1267565 | Collegium Pharmaceutical Inc | COLL | Pharmaceutical Preparations (2834) | 000000000 |
Insiders
| Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
|---|---|---|---|---|---|---|---|
| 1296771 | Gordon John Freund | C/O Skyline Venture Partners V, L.p. 525 University Ave. Palo Alto CA 94301 | Yes | No | Yes | No |
Reported Non-Derivative Transactions
| Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock | Acquisiton | 2015-05-12 | 1,552,795 | $0.00 | 1,552,795 | No | 4 | C | Indirect | By Skyline Venture Partners V, L.P. |
| Common Stock | Acquisiton | 2015-05-12 | 382,323 | $0.00 | 1,935,118 | No | 4 | C | Indirect | By Skyline Venture Partners V, L.P. |
| Common Stock | Acquisiton | 2015-05-12 | 864,798 | $0.00 | 2,799,916 | No | 4 | C | Indirect | By Skyline Venture Partners V, L.P. |
| Common Stock | Acquisiton | 2015-05-12 | 150,000 | $12.00 | 2,949,916 | No | 4 | P | Indirect | By Skyline Venture Partners V, L.P. |
| Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|
| No | 4 | C | Indirect | By Skyline Venture Partners V, L.P. |
| No | 4 | C | Indirect | By Skyline Venture Partners V, L.P. |
| No | 4 | C | Indirect | By Skyline Venture Partners V, L.P. |
| No | 4 | P | Indirect | By Skyline Venture Partners V, L.P. |
Reported Derivative Transactions
| Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
|---|---|---|---|---|---|---|---|
| Common Stock | Series B Convertible Stock | Disposition | 2015-05-12 | 10,714,286 | $0.00 | 1,552,795 | $0.00 |
| Common Stock | Series C Convertible Stock | Disposition | 2015-05-12 | 2,638,030 | $0.00 | 382,323 | $0.00 |
| Common Stock | Series D Convertible Stock | Disposition | 2015-05-12 | 5,881,724 | $0.00 | 864,798 | $0.00 |
| Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
|---|---|---|---|---|---|---|
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect |
Footnotes
- All series of Convertible Preferred Stock automatically converted into Collegium Pharmaceutical, Inc. common stock on a 1-for-6.9 basis immediately prior to the closing of the initial public offering and had no expiration date.
- Reflects the conversion of preferred stock into Collegium Pharmaceutical, Inc. common stock on a 1-for-6.9 basis which became effective on May 12, 2015.
- The shares are held by Skyline Venture Partners V, L.P. The general partner of Skyline Venture Partners V, L.P. is Skyline Venture Management V, LLC. John G. Freund and Yasunori Kaneko are managers of Skyline Venture Management V, LLC. These individuals share voting and investment power over the shares held by Skyline Venture Management, LLC. Dr. Freund disclaims beneficial ownership of all the shares held by Skyline Venture Partners V, L.P. except to the extent of his proportionate pecuniary interest therein.
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