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) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series C Participating Convertible Preferred Stock
|
Â
(4)
|
Â
(4)
|
Common Stock
|
5,936
(1)
(4)
|
$
0
(4)
|
I
|
By Media Power Limited Partnership
(2)
|
* |
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) |
Does not reflect a 9 for 1 stock split, which the Issuer intends to effect through a dividend of 8 shares of its common stock for each share of its commn stock outstanding immediately prior to the consummation of the Issuer's initial public offering. |
(2) |
The reporting person is the chairman of the general partner of Media Power Limited Partnership. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. |
(3) |
The reporting person is a managing partner of the general partner of Cherry Tree Ventures IV Limited Partnership. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. |
(4) |
The series C participating convertible preferred stock is convertible into common stock at any time at the holder?s election on approximately a 1 to 14.84 basis, and has no expiration date. The Issuer has exercised its right to require the conversion of these shares. Therefore, each outstanding share of series C participating convertible preferred stock will convert into approximately 14.84 shares of common stock upon the consummation of the Issuer?s initial public offering. |