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Inogen Inc — Director's Dealing 2014
Feb 13, 2014
33625_dirs_2014-02-12_a8575519-9c8d-4767-b719-f8bea117422f.zip
Director's Dealing
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SEC Form 3 — Initial Statement of Beneficial Ownership
Issuer: Inogen Inc (INGN)
CIK: 0001294133
Period of Report: 2014-02-12
Reporting Person: Petersen Timothy (Director, 10% Owner)
Holdings (Non-Derivative)
| Security | Shares | Ownership |
|---|---|---|
| Common Stock | 10432 | Indirect |
| Common Stock | 6954 | Indirect |
Holdings (Derivative)
| Security | Exercise Price | Expiration | Underlying | Shares | Ownership |
|---|---|---|---|---|---|
| Series D Preferred Stock | $0.00 | Common Stock (59931) | Indirect | ||
| Series E Preferred Stock | $0.00 | Common Stock (53548) | Indirect | ||
| Series F Preferred Stock | $0.00 | Common Stock (33612) | Indirect | ||
| Series D Preferred Stock | $0.00 | Common Stock (39953) | Indirect | ||
| Series E Preferred Stock | $0.00 | Common Stock (35698) | Indirect | ||
| Series F Preferred Stock | $0.00 | Common Stock (22408) | Indirect | ||
| Series D Preferred Stock | $0.00 | Common Stock (23121) | Indirect | ||
| Series F Preferred Stock | $0.00 | Common Stock (975846) | Indirect | ||
| Series G Preferred Stock | $0.00 | Common Stock (345168) | Indirect | ||
| Series D Preferred Stock | $0.00 | Common Stock (5417) | Indirect | ||
| Series F Preferred Stock | $0.00 | Common Stock (228636) | Indirect | ||
| Series G Preferred Stock | $0.00 | Common Stock (80871) | Indirect |
Footnotes
F1: Each share of (i) Series D Preferred Stock will automatically convert into 1.879505664 shares of Common Stock, (ii) Series E Preferred Stock will automatically convert into 2.692436975 shares of Common Stock, (iii) Series F Preferred Stock will automatically convert into 1 share of Common Stock, and (iv) Series G Preferred Stock will automatically convert into 1 share of Common Stock upon the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date.
F2: These shares are held by Arboretum Ventures 1, LLC ("Ventures 1"). Arboretum Investment Manager, LLC ("AIM") serves as the managing member of Ventures 1. Arboretum Ventures, Inc. ("INC") serves as the Manager of AIM. Timothy Petersen is a shareholder of INC and may be deemed to have voting and investment power with respect to such shares. The reporting person disclaims beneficial ownership of the shares reported herein, except to the extent of his pecuniary interest therein.
F3: These shares are held by Arboretum Ventures 1-A, LLC ("Ventures 1-A"). AIM serves as the managing member of Ventures 1-A. INC serves as the Manager of AIM. Timothy Petersen is a shareholder of INC and may be deemed to have voting and investment power with respect to such shares. The reporting person disclaims beneficial ownership of the shares reported herein, except to the extent of his pecuniary interest therein.
F4: These shares are held by Arboretum Ventures II, L.P ("Ventures II"). Arboretum Investment Manager II, LLC ("AIM II") serves as the general partner of Ventures II. Timothy Petersen is a managing member of AIM II and may be deemed to have voting and investment power with respect to such shares. The reporting person disclaims beneficial ownership of the shares reported herein, except to the extent of his pecuniary interest therein.
F5: These shares are held by Arboretum Ventures IIa, L.P ("Ventures IIa). AIM II serves as the sole manager of Arboretum Investment Manager IIa, LLC ("AIM IIa"), which serves as the general partner of Ventures IIa. Timothy Petersen is a managing member of AIM II and may be deemed to have voting and investment power with respect to such shares. The reporting person disclaims beneficial ownership of the shares reported herein, except to the extent of his pecuniary interest therein.