UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option | 01/31/2009 | 01/31/2022 | Common Stock | 26,743 | $ 0.415 | D | |
Stock Option | (1) | 07/19/2023 | Common Stock | 21,000 | $ 5 | D | |
Warrant | 05/22/2012 | 05/22/2019 | Common Stock | 23,706 | $ 6.3276 | D | |
Convertible Promissory Note | 10/09/2011 | (2) | Common Stock | 9,018 | $ 5 | D | |
Convertible Promissory Note | 05/22/2012 | (2) | Common Stock | 33,031 | $ 5 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
De Tarr Charles 5004 BEE CREEK ROAD SUITE 600 SPICEWOOD, TX 78669 |
X | VP Finance |
/s/ Charles De Tarr | 11/21/2013 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The right to purchase one-third of the shares of common stock vests on each of December 31, 2013, December 31, 2014 and December 31, 2015. |
(2) | The convertible promissory note will be paid on the earlier of (i) the completion of the Company's initial public offering or (ii) December 31, 2013. Upon the completion of an initial public offering, the convertible promissory note, including all accrued interest, will be paid with shares of the Company's common stock at the public offering price. For purposes of this report, we have accrued shares for the payment of interest through the date of filing. |