Filing Details
- Accession Number:
- 0001192482-15-000207
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2015-05-14 16:06:49
- Reporting Period:
- 2015-05-12
- Filing Date:
- 2015-05-14
- Accepted Time:
- 2015-05-14 16:06:49
- 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 |
|---|---|---|---|---|---|---|---|
| 1365617 | J Patrick Heron | C/O Frazier Healthcare Vi, L.p. 601 Union Street, Suite 3200 Seattle WA 98101 | 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 | 582,490 | $0.00 | 582,490 | No | 4 | C | Indirect | By Frazier Healthcare VI, L.P. |
| Common Stock | Acquisiton | 2015-05-12 | 222,231 | $0.00 | 804,721 | No | 4 | C | Indirect | By Frazier Healthcare VI, L.P. |
| Common Stock | Acquisiton | 2015-05-12 | 392,113 | $0.00 | 1,196,834 | No | 4 | C | Indirect | By Frazier Healthcare VI, L.P. |
| Common Stock | Acquisiton | 2015-05-12 | 540,498 | $0.00 | 1,737,332 | No | 4 | C | Indirect | By Frazier Healthcare VI, L.P. |
| Common Stock | Acquisiton | 2015-05-12 | 150,000 | $12.00 | 1,887,332 | No | 4 | P | Indirect | By Frazier Healthcare VI, L.P. |
| Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|
| No | 4 | C | Indirect | By Frazier Healthcare VI, L.P. |
| No | 4 | C | Indirect | By Frazier Healthcare VI, L.P. |
| No | 4 | C | Indirect | By Frazier Healthcare VI, L.P. |
| No | 4 | C | Indirect | By Frazier Healthcare VI, L.P. |
| No | 4 | P | Indirect | By Frazier Healthcare VI, L.P. |
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 | Indirect | ||
| 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 Frazier Healthcare VI, L.P. The general partner of Frazier Healthcare VI, L.P. is FHM VI, L.P., a limited partnership, the general partner of which is FHM VI, LLC. The members of FHM VI, LLC are Dr. Nathan Every, Alan Frazier, Nader Naini, Patrick Heron, and Dr. James Topper. These individuals share voting and investment power over the shares held by Frazier Healthcare VI, L.P. Mr. Heron disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest.
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