Filing Details
- Accession Number:
- 0001192482-15-000206
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2015-05-14 16:06:05
- Reporting Period:
- 2015-05-12
- Filing Date:
- 2015-05-14
- Accepted Time:
- 2015-05-14 16:06:05
- 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 |
---|---|---|---|---|---|---|---|
1018534 | D Alan Frazier | C/O Frazier Healthcare Vi, L.p. 601 Union Street, Suite 3200 Seattle WA 98101 | No | No | Yes | No | |
1341382 | N James Topper | C/O Frazier Healthcare Vi, L.p. 601 Union Street, Suite 3200 Seattle WA 98101 | No | No | Yes | No | |
1344203 | J Nader Naini | C/O Frazier Healthcare Vi, L.p. 601 Union Street, Suite 3200 Seattle WA 98101 | No | No | Yes | No | |
1456654 | Fhm Vi, L.l.c. | 601 Union Street, Suite 3200 Seattle WA 98101 | No | No | Yes | No | |
1456655 | Fhm Vi, L.p. | 601 Union Street, Suite 3200 Seattle WA 98101 | No | No | Yes | No | |
1456656 | Frazier Healthcare Vi, L.p. | 601 Union Street, Suite 3200 Seattle WA 98101 | No | No | Yes | No | |
1531105 | R Nathan Every | C/O Frazier Healthcare Vi, L.p. 601 Union Street, Suite 3200 Seattle WA 98101 | 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 | 582,490 | $0.00 | 582,490 | No | 4 | C | Direct | |
Common Stock | Acquisiton | 2015-05-12 | 222,231 | $0.00 | 804,721 | No | 4 | C | Direct | |
Common Stock | Acquisiton | 2015-05-12 | 392,113 | $0.00 | 1,196,834 | No | 4 | C | Direct | |
Common Stock | Acquisiton | 2015-05-12 | 540,498 | $0.00 | 1,737,332 | No | 4 | C | Direct | |
Common Stock | Acquisiton | 2015-05-12 | 150,000 | $12.00 | 1,887,332 | No | 4 | P | Direct |
Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
---|---|---|---|---|
No | 4 | C | Direct | |
No | 4 | C | Direct | |
No | 4 | C | Direct | |
No | 4 | C | Direct | |
No | 4 | P | Direct |
Reported Derivative Transactions
Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
---|---|---|---|---|---|---|---|
Common Stock | Series A Convertible Stock | Disposition | 2015-05-12 | 4,019,183 | $0.00 | 582,490 | $0.00 |
Common Stock | Series B Convertible Stock | Disposition | 2015-05-12 | 1,533,399 | $0.00 | 222,231 | $0.00 |
Common Stock | Series C Convertible Stock | Disposition | 2015-05-12 | 2,705,585 | $0.00 | 392,113 | $0.00 |
Common Stock | Series D Convertible Stock | Disposition | 2015-05-12 | 3,676,078 | $0.00 | 540,498 | $0.00 |
Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
---|---|---|---|---|---|---|
0 | No | 4 | C | Direct | ||
0 | No | 4 | C | Direct | ||
0 | No | 4 | C | Direct | ||
0 | No | 4 | C | Direct |
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.
- This report is filed jointly by Frazier Healthcare VI, L.P. ("FHVI"), FHM VI, L.P. ("FHM LP"), FHM VI, LLC ("FHM LLC"), Nathan Every ("Every"), Alan Frazier ("Frazier"), Patrick Heron ("Heron"), Nader Naini ("Naini") and James Topper ("Topper"). The shares are held by FHVI. The general partner of FHVI is FHM LP, a limited partnership, the general partner of which is FHM LLC. The members of FHM LLC are Every, Frazier, Naini, Heron, and Topper. These individuals share voting and investment power over the shares held by FHVI. Each of these individuals disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest.