Filing Details

Accession Number:
0001209191-15-042578
Form Type:
4
Zero Holdings:
No
Publication Time:
2015-05-13 21:41:12
Reporting Period:
2015-05-12
Filing Date:
2015-05-13
Accepted Time:
2015-05-13 21:41:12
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
1277503 Yasunori Kaneko 525 University Avenue, Suite 610
Palo Alto CA 94301
No No Yes No
1419187 Skyline Venture Partners V Lp 525 University Avenue, Suite 610
Palo Alto CA 94301
No No Yes No
1434887 Skyline Venture Management V, Llc 525 University Avenue, Suite 610
Palo Alto CA 94301
No 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 see footnote
Common Stock Acquisiton 2015-05-12 382,323 $0.00 1,935,118 No 4 C Indirect see footnote
Common Stock Acquisiton 2015-05-12 864,798 $0.00 2,799,916 No 4 C Indirect see footnote
Common Stock Acquisiton 2015-05-12 150,000 $12.00 2,949,916 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 P Indirect see footnote
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series B Convertible Preferred Stock Disposition 2015-05-12 10,714,286 $0.00 1,552,795 $0.00
Common Stock Series C Convertible Preferred Stock Disposition 2015-05-12 2,638,030 $0.00 382,323 $0.00
Common Stock Series D Convertible Preferred 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
  1. 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.
  2. 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.
  3. 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 and disclaim beneficial ownership of all the shares held by Skyline Venture Partners V, L.P. except to the extent of their proportionate pecuniary interest therein. Dr. Freund is a director of the Issuer and, accordingly, files separate Section 16 reports.