Filing Details
- Accession Number:
- 0001209191-11-057456
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2011-11-21 21:36:26
- Reporting Period:
- 2011-11-21
- Filing Date:
- 2011-11-21
- Accepted Time:
- 2011-11-21 21:36:26
- SEC Url:
- Form 4 Filing
Issuer
Cik | Name | Symbol | Sector (SIC) | IRS No |
---|---|---|---|---|
1466301 | Clovis Oncology Inc. | CLVS | Pharmaceutical Preparations (2834) | 900475355 |
Insiders
Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
---|---|---|---|---|---|---|---|
1266569 | J Patrick Mahaffy | C/O Clovis Oncology, Inc. 2525 28Th Street, Suite 100 Boulder CO 80301 | President And Ceo | Yes | Yes | No | 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 | 2011-11-21 | 17,835 | $0.00 | 828,181 | No | 4 | C | Direct | |
Common Stock | Acquisiton | 2011-11-21 | 17,835 | $0.00 | 846,016 | No | 4 | C | Direct | |
Common Stock | Acquisiton | 2011-11-21 | 38,605 | $0.00 | 884,621 | No | 4 | C | Direct | |
Common Stock | Acquisiton | 2011-11-21 | 16,239 | $0.00 | 900,860 | No | 4 | C | Direct | |
Common Stock | Acquisiton | 2011-11-21 | 39,927 | $13.00 | 940,787 | 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-1 Convertible Preferred Stock | Disposition | 2011-11-21 | 51,724 | $0.00 | 17,835 | $0.00 |
Common Stock | Series A-2 Convertible Preferred Stock | Disposition | 2011-11-21 | 51,724 | $0.00 | 17,835 | $0.00 |
Common Stock | Series B Convertible Preferred Stock | Disposition | 2011-11-21 | 111,957 | $0.00 | 38,605 | $0.00 |
Common Stock | Convertible Promissory Notes | Disposition | 2011-11-21 | 0 | $0.00 | 16,239 | $13.00 |
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
- The reported securities were convertible at any time, in whole or in part, at the option of the reporting person, had no expiration date, and automatically converted into shares of Common Stock on November 21, 2011, the closing of the Issuer's initial public offering, on a 2.9 for 1 basis.
- The outstanding $206,000 principal amount of these 5% convertible promissory notes due May 25, 2012 and all accrued and unpaid interest thereon from and after May 25, 2011 automatically converted into shares of Common Stock on November 21, 2011, the closing of the Issuer's initial public offering, at a conversion price of $13.00, the per share price to the public of the Common Stock sold in the Issuer's initial public offering.