FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
EnteroMedics Inc [ ETRM ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/20/2007 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 11/20/2007 | C | 1,359,261 | A | (1) | 1,546,761 | I | By: InterWest Partners IX, LP(2) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series C Preferred Stock | (1) | 11/20/2007 | C | 1,359,261 | (1) | (1) | Common Stock | 1,359,261 | $0 | 0 | I(2) | by: InterWest Partners IX, LP |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. Each share of Series C Preferred Stock was automatically converted into one share of Common Stock upon the closing of the Issuer's initial public offering on 11/20/07. |
2. The shares are owned by InterWest Partners IX, LP ("IW9"). InterWest Management Partners IX, LLC ("IMP9") is the general partner of IW9. Harvey B. Cash, Philip T. Gianos, W. Stephen Holmes, Gilbert H. Kliman, Arnold L. Oronsky, Thomas L. Rosch, and Michael B. Sweeney are Managing Directors of IMP9. Michael D. Boich, Bruce A. Cleveland, Christopher B. Ehrlich, Linda S. Grais, Ellen E. Koskinas, Nina Kjellson, H. Ronald Nash, Khaled A. Nasr, Douglas A. Pepper, and Victor A. Westerlind are Venture Members of IMP9. Each Managing Director and Venture Member of IMP9 disclaims beneficial ownership of such shares, except to the extent of their pecuniary interest therein. |
Remarks: |
Due to limitations of the EDGAR software, this Form 4 is filed on behalf of InterWest Partners IX, LP and certain other Reporting Persons, and is being filed on two Forms 4 (Part I and Part II) (collectively, the "InterWest Form 4"). This filing represents Part II of the InterWest Form 4 and should be read together with Part I. Part I and Part II of the InterWest Form 4 shall constitute one filing. |
/s/ Gilbert H. Kliman, Managing Director | 11/21/2007 | |
/s/ Christopher B. Ehrlich by Karen A. Wilson Power of Attorney | 11/21/2007 | |
/s/ Linda S. Grais by Karen A. Wilson Power of Attorney | 11/21/2007 | |
/s/ Nina Kjellson by Karen A. Wilson Power of Attorney | 11/21/2007 | |
/s/ H. Ronald Nash by Karen A. Wilson Power of Attorney | 11/21/2007 | |
/s/ Khaled A. Nasr by Karen A. Wilson Power of Attorney | 11/21/2007 | |
/s/ Douglas A. Pepper by Karen A. Wilson Power of Attorney | 11/21/2007 | |
/s/ Victor A. Westerlind by Karen A. Wilson Power of Attorney | 11/21/2007 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |
Name of |
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Reporting Persons:
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InterWest Partners IX, L.P. (IW9) | |
InterWest Management Partners IX, LLC (IMP9) | ||
Harvey B. Cash | ||
Philip T. Gianos | ||
W. Stephen Holmes | ||
Gilbert H. Kliman | ||
Arnold L. Oronsky | ||
Thomas L. Rosch | ||
Michael B. Sweeney | ||
Michael D. Boich | ||
Bruce A. Cleveland | ||
Christopher B. Ehrlich | ||
Linda S. Grais | ||
Nina Kjellson | ||
H. Ronald Nash | ||
Khaled A. Nasr | ||
Douglas A. Pepper | ||
Victor A. Westerlind | ||
Address:
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2710 Sand Hill Road, Second Floor Menlo Park, CA 94025 |
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Designated Filer:
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InterWest Partners IX, L.P. | |
Issuer and Ticker Symbol:
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EnteroMedics Inc. (ETRM) | |
Date of Event:
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November 20, 2007 |
1.
InterWest Management Partners IX, L.L.C. | Thomas L. Rosch, an individual | |||||||
By: | InterWest Management Partners IX, LLC, | |||||||
as Attorney-in-Fact |
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By:
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/s/ Gilbert H. Kliman | By: | /s/ Karen A. Wilson | |||||
Gilbert H. Kliman, Managing Director | Karen A. Wilson, Power of Attorney | |||||||
InterWest Partners IX, LP | Michael B. Sweeney, an individual | |||||||
By: | InterWest Management Partners IX, LLC, | |||||||
By:
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InterWest Management Partners IX, LLC Its General Partner |
as Attorney-in-Fact | ||||||
By:
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/s/ Gilbert H. Kliman | By: | /s/ Karen A. Wilson | |||||
Gilbert H. Kliman, Managing Director | Karen A. Wilson, Power of Attorney | |||||||
Harvey B. Cash, an individual | Michael D. Boich, an individual | |||||||
By:
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InterWest Management Partners IX, LLC, as Attorney-in-Fact |
By: | InterWest Management Partners IX, LLC, as Attorney-in-Fact |
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By:
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/s/ Karen A. Wilson | By: | /s/ Karen A. Wilson | |||||
Karen A. Wilson, Power of Attorney | Karen A. Wilson, Power of Attorney | |||||||
Philip T. Gianos, an individual | Bruce A. Cleveland, an individual | |||||||
By:
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InterWest Management Partners IX, LLC, as Attorney-in-Fact |
By: | InterWest Management Partners IX, LLC, as Attorney-in-Fact |
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By:
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/s/ Karen A. Wilson | By: | /s/ Karen A. Wilson | |||||
Karen A. Wilson, Power of Attorney | Karen A. Wilson, Power of Attorney | |||||||
W. Stephen Holmes, an individual | Christopher B. Ehrlich, an individual | |||||||
By:
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InterWest Management Partners IX, LLC, as Attorney-in-Fact |
By: | InterWest Management Partners IX, LLC, as Attorney-in-Fact |
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By:
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/s/ Karen A. Wilson | By: | /s/ Karen A. Wilson | |||||
Karen A. Wilson, Power of Attorney | Karen A. Wilson, Power of Attorney | |||||||
Gilbert H. Kliman, an individual | Linda S. Grais, an individual | |||||||
By:
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InterWest Management Partners IX, LLC, as Attorney-in-Fact |
By: | InterWest Management Partners IX, LLC, as Attorney-in-Fact |
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By:
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/s/ Karen A. Wilson | By: | /s/ Karen A. Wilson | |||||
Karen A. Wilson, Power of Attorney | Karen A. Wilson, Power of Attorney | |||||||
Arnold L. Oronsky, an individual | Nina Kjellson, an individual | |||||||
By:
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InterWest Management Partners IX, LLC, as Attorney-in-Fact |
By: | InterWest Management Partners IX, LLC, as Attorney-in-Fact |
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By:
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/s/ Karen A. Wilson | By: | /s/ Karen A. Wilson | |||||
Karen A. Wilson, Power of Attorney | Karen A. Wilson, Power of Attorney |
2.
H. Ronald Nash, an individual | ||||||||
By:
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InterWest Management Partners IX, LLC, | |||||||
as Attorney-in-Fact | ||||||||
By:
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/s/ Karen A. Wilson | |||||||
Karen A. Wilson, Power of Attorney | ||||||||
Khaled A. Nasr, an individual | ||||||||
By:
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InterWest Management Partners IX, LLC, | |||||||
as Attorney-in-Fact | ||||||||
By:
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/s/ Karen A. Wilson | |||||||
Karen A. Wilson, Power of Attorney | ||||||||
Douglas A. Pepper, an individual | ||||||||
By:
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InterWest Management Partners IX, LLC, | |||||||
as Attorney-in-Fact | ||||||||
By:
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/s/ Karen A. Wilson | |||||||
Karen A. Wilson, Power of Attorney | ||||||||
Victor A. Westerlind, an individual | ||||||||
By:
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InterWest Management Partners IX, LLC, | |||||||
as Attorney-in-Fact | ||||||||
By:
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/s/ Karen A. Wilson | |||||||
Karen A. Wilson, Power of Attorney |
3.