Sec Form 4 Filing - White Daniel H. @ Clearside Biomedical, Inc. - 2016-06-07

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, 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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1. Name and Address of Reporting Person
White Daniel H.
2. Issuer Name and Ticker or Trading Symbol
Clearside Biomedical, Inc. [ CLSD]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
President and CEO
(Last) (First) (Middle)
C/O CLEARSIDE BIOMEDICAL, INC., 1220 OLD ALPHARETTA ROAD, SUITE 300
3. Date of Earliest Transaction (MM/DD/YY)
06/07/2016
(Street)
ALPHARETTA, GA30005
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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 06/07/2016 C 66,518 ( 1 ) A 530,163 D
Common Stock 06/07/2016 X 657 A $ 0.022 530,820 D
Common Stock 06/07/2016 S( 3 ) 3 D $ 7 530,817 D
Common Stock 40,909 I By White Family Trust ( 4 )
Common Stock 301 I As UTMA custodian for son ( 5 )
Common Stock 844 I As UTMA custodian for son ( 5 )
Common Stock 1,188 I As UTMA custodian for son ( 5 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially O wned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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 A Preferred Stock ( 2 ) 06/07/2016 C 133,234 ( 2 ) ( 2 ) Common Stock 60,560 $ 0 0 D
Series B Preferred Stock ( 2 ) 06/07/2016 C 13,110 ( 2 ) ( 2 ) Common Stock 5,958 $ 0 0 D
Warrant to Purchase Common Stock (right to buy) $ 0.022 06/07/2016 X 657 04/28/2014 ( 6 ) Common Stock 657 $ 0 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
White Daniel H.
C/O CLEARSIDE BIOMEDICAL, INC.
1220 OLD ALPHARETTA ROAD, SUITE 300
ALPHARETTA, GA30005
X President and CEO
Signatures
/s/ Brian F. Leaf, Attorney-in-Fact 06/07/2016
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents shares received upon conversion of shares of Series A Preferred Stock and Series B Preferred Stock.
( 2 )Effective immediately prior to the closing of the Issuer's initial public offering of its common stock, each share of Series A Preferred Stock and Series B Preferred Stock automatically converted into 0.454545 shares of the Issuer's common stock. The Preferred Stock had no expiration date.
( 3 )On June 7, 2016, the reporting person exercised a warrant to purchase 657 shares of Issuer's common stock for $0.022 per share. The reporting person paid the exercise price on a cashless basis, resulting in the issuer's withholding of 3 of the warrant shares to pay the exercise price and issuing to the reporting person the remaining 654 shares.
( 4 )These securities are held in trust for the benefit of the reporting person's children. The reporting person's wife serves as trustee of the trust. The reporting person disclaims beneficial ownership of these securities, 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.
( 5 )These securities are held for the benefit of the reporting person's son under the Georgia Uniform Transfers to Minors Act, for which the reporting person serves as custodian. The reporting person disclaims beneficial ownership of these shares, and this report shall not be deemed an admission that the reporting person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose.
( 6 )This warrant would have expired upon the closing of the Issuer's initial public offering.

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