4//SEC Filing
HAQUE PROMOD 4
Accession 0001209191-21-029115
CIK 0001445499other
Filed
Apr 28, 8:00 PM ET
Accepted
Apr 29, 7:45 PM ET
Size
18.1 KB
Accession
0001209191-21-029115
Insider Transaction Report
Form 4
Kossow Jon Erik
10% Owner
Transactions
- Conversion
Common Stock
2021-04-27$13.50/sh+98,927$1,335,515→ 98,927 total - Conversion
Series D Preferred Stock
2021-04-27−35,256,206→ 0 total→ Common Stock (2,153,271 underlying) - Purchase
Common Stock
2021-04-27$15.00/sh+825,000$12,375,000→ 3,077,198 total - Conversion
5% Convertible Note due 2021
2021-04-27→ 0 totalExercise: $13.50Exp: 2021-12-31→ Common Stock (98,927 underlying) - Conversion
Common Stock
2021-04-27+2,153,271→ 2,252,198 total
Norwest Venture Partners XIV, LP
10% Owner
Transactions
- Purchase
Common Stock
2021-04-27$15.00/sh+825,000$12,375,000→ 3,077,198 total - Conversion
5% Convertible Note due 2021
2021-04-27→ 0 totalExercise: $13.50Exp: 2021-12-31→ Common Stock (98,927 underlying) - Conversion
Common Stock
2021-04-27$13.50/sh+98,927$1,335,515→ 98,927 total - Conversion
Common Stock
2021-04-27+2,153,271→ 2,252,198 total - Conversion
Series D Preferred Stock
2021-04-27−35,256,206→ 0 total→ Common Stock (2,153,271 underlying)
Crowe Jeffrey
10% Owner
Transactions
- Conversion
Common Stock
2021-04-27$13.50/sh+98,927$1,335,515→ 98,927 total - Purchase
Common Stock
2021-04-27$15.00/sh+825,000$12,375,000→ 3,077,198 total - Conversion
Series D Preferred Stock
2021-04-27−35,256,206→ 0 total→ Common Stock (2,153,271 underlying) - Conversion
Common Stock
2021-04-27+2,153,271→ 2,252,198 total - Conversion
5% Convertible Note due 2021
2021-04-27→ 0 totalExercise: $13.50Exp: 2021-12-31→ Common Stock (98,927 underlying)
HAQUE PROMOD
10% Owner
Transactions
- Conversion
5% Convertible Note due 2021
2021-04-27→ 0 totalExercise: $13.50Exp: 2021-12-31→ Common Stock (98,927 underlying) - Conversion
Common Stock
2021-04-27+2,153,271→ 2,252,198 total - Purchase
Common Stock
2021-04-27$15.00/sh+825,000$12,375,000→ 3,077,198 total - Conversion
Common Stock
2021-04-27$13.50/sh+98,927$1,335,515→ 98,927 total - Conversion
Series D Preferred Stock
2021-04-27−35,256,206→ 0 total→ Common Stock (2,153,271 underlying)
Footnotes (3)
- [F1]The securities shown represent securities held of record by Norwest Venture Partners XIV, LP ("NVP XIV"). Genesis VC Partners XIV, LLC ("Genesis XIV") is the general partner of NVP XIV and may be deemed to have sole voting and dispositive power over the shares held by NVP XIV. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XIV, and Jeffrey Crowe, Promod Haque and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities and Messrs. Crowe, Haque and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.
- [F2]The shares of the Issuer's Series D Preferred Stock automatically converted into the number of shares of the Issuer's Common Stock on a 16.37332-for-one basis, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of Common Stock (the "IPO") and had no expiration date.
- [F3]The convertible promissory note was issued by the Issuer in March 2021 and the outstanding principal and accrued interest automatically converted into the number of shares of the Issuer's Common Stock set forth above upon the closing of the IPO at $13.50 per share (90% of the IPO price).
Documents
Issuer
IMPEL NEUROPHARMA INC
CIK 0001445499
Entity typeother
IncorporatedCA
Related Parties
1- filerCIK 0001089744
Filing Metadata
- Form type
- 4
- Filed
- Apr 28, 8:00 PM ET
- Accepted
- Apr 29, 7:45 PM ET
- Size
- 18.1 KB