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MCINERNEY THOMAS E 4

Accession 0000904454-09-000606

CIK 0001421419other

Filed

Oct 27, 8:00 PM ET

Accepted

Oct 28, 3:43 PM ET

Size

18.1 KB

Accession

0000904454-09-000606

Insider Transaction Report

Form 4
Period: 2009-10-26
Transactions
  • Conversion

    Series A Preferred Stock

    2009-10-266,5240 total(indirect: By WCAS Capital Partners IV, L.P.)
    Common Stock (1,103,241 underlying)
  • Conversion

    Common Stock

    2009-10-26+19,749,60323,913,988 total(indirect: By Welsh, Carson, Anderson & Stowe IX, L.P.)
  • Conversion

    Common Stock

    2009-10-26+65,61383,551 total
  • Conversion

    Common Stock

    2009-10-26+1,210,1971,210,197 total(indirect: By WCAS Capital Partners IV, L.P.)
  • Conversion

    Series A Preferred Stock

    2009-10-26116,7890 total(indirect: By Welsh, Carson, Anderson & Stowe IX, L.P.)
    Common Stock (19,749,603 underlying)
  • Conversion

    Series A Preferred Stock

    2009-10-263880 total
    Common Stock (65,613 underlying)
  • Conversion

    Series B Preferred Stock

    2009-10-261,8790 total(indirect: By WCAS Capital Partners IV, L.P.)
    Common Stock (106,956 underlying)
Footnotes (3)
  • [F1]Upon consummation of the Issuer's initial public offering, each share of Preferred Stock automatically converted into Common Stock, for no additional consideration. The number of shares of Common Stock received upon conversion of Preferred Stock included shares issued in payment of accrued and unpaid dividends on such Preferred Stock as of the date of conversion.
  • [F2]Reflects the 7.15 for 1 reverse split of the Common Stock effective concurrently with the conversion of the Preferred Stock.
  • [F3]The Reporting Person is a managing member of the respective sole general partners of Welsh, Carson, Anderson & Stowe IX, L.P. and WCAS Capital Partners IV, L.P. Pursuant to Instruction (4)(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him.

Issuer

AGA Medical Holdings, Inc.

CIK 0001421419

Entity typeother

Related Parties

1
  • filerCIK 0001212989

Filing Metadata

Form type
4
Filed
Oct 27, 8:00 PM ET
Accepted
Oct 28, 3:43 PM ET
Size
18.1 KB