Sec Form 4 Filing - Vivo Capital VIII, LLC @ IMPEL NEUROPHARMA INC - 2021-04-27

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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
Vivo Capital VIII, LLC
2. Issuer Name and Ticker or Trading Symbol
IMPEL NEUROPHARMA INC [ IMPL]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O VIVO CAPITAL LLC, 192 LYTTON AVENUE
3. Date of Earliest Transaction (MM/DD/YY)
04/27/2021
(Street)
PALO ALTO, CA94301
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ 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 04/27/2021 C 710,190 A 710,190 I See footnote ( 3 )
Common Stock 04/27/2021 C 98,068 A 98,068 I See footnote ( 4 )
Common Stock 04/27/2021 C 474,713 A 1,184,903 I See footnote ( 3 )
Common Stock 04/27/2021 C 65,552 A 163,620 I See footnote ( 4 )
Common Stock 04/27/2021 C 440,119 A 1,625,022 I See footnote ( 3 )
Common Stock 04/27/2021 C 60,813 A 224,433 I See footnote ( 4 )
Common Stock 04/27/2021 C 315,328 A 1,940,350 I See footnote ( 3 )
Common Stock 04/27/2021 C 43,550 A 267,983 I See footnote ( 4 )
Common Stock 04/27/2021 C 89,145 A $ 13.5 ( 2 ) 2,029,495 I See footnote ( 3 )
Common Stock 04/27/2021 C 12,311 A $ 13.5 ( 2 ) 280,294 I See footnote ( 4 )
Common Stock 04/27/2021 P 505,620 A $ 15 2,535,115 I See footnote ( 3 )
Common Stock 04/27/2021 P 69,380 A $ 15 349,674 I See footnote ( 4 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( 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 C-1 Redeemable Convertible Preferred Stock ( 1 ) 04/27/2021 C 11,628,174 ( 1 ) ( 1 ) Common Stock 710,190 $ 0 0 I See footnote ( 3 )
Series C-1 Redeemable Convertible Preferred Stock ( 1 ) 04/27/2021 C 1,605,711 ( 1 ) ( 1 ) Common Stock 98,068 $ 0 0 I See footnote ( 4 )
Series C-2 Redeemable Convertible Preferred Stock ( 1 ) 04/27/2021 C 7,772,634 ( 1 ) ( 1 ) Common Stock 474,713 $ 0 0 I See footnote ( 3 )
Series C-2 Redeemable Convertible Preferred Stock ( 1 ) 04/27/2021 C 1,073,308 ( 1 ) ( 1 ) Common Stock 65,552 $ 0 0 I See footnote ( 4 )
Series C-3 Redeemable Convertible Preferred Stock ( 1 ) 04/27/2021 C 7,206,216 ( 1 ) ( 1 ) Common Stock 440,119 $ 0 0 I See footnote ( 3 )
Series C-3 Redeemable Convertible Preferred Stock ( 1 ) 04/27/2021 C 995,714 ( 1 ) ( 1 ) Common Stock 60,813 $ 0 0 I See footnote ( 4 )
Series D Redeemable Convertible Preferred Stock ( 1 ) 04/27/2021 C 5,162,969 ( 1 ) ( 1 ) Common Stock 315,328 $ 0 0 I See footnote ( 3 )
Series D Redeemable Convertible Preferred Stock ( 1 ) 04/27/2021 C 713,064 ( 1 ) ( 1 ) Common Stock 43,550 $ 0 0 I See footnote ( 4 )
5% Convertible Note due 2021 $ 13.5 ( 2 ) 04/27/2021 C ( 2 ) 12/31/2021 Common Stock 89,145 $ 0 0 I See footnote ( 3 )
5% Convertible Note due 2021 $ 13.5 ( 2 ) 04/27/2021 C ( 2 ) 12/31/2021 Common Stock 12,311 $ 0 0 I See footnote ( 4 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Vivo Capital VIII, LLC
C/O VIVO CAPITAL LLC
192 LYTTON AVENUE
PALO ALTO, CA94301
X
Vivo Capital Fund VIII, L.P.
192 LYTTON AVENUE
PALO ALTO, CA94301
X
Vivo Capital Surplus Fund VIII, L.P.
192 LYTTON AVENUE
PALO ALTO, CA94301
X
Signatures
/s/ Frank Kung, as a managing member of Vivo Capital VIII, LLC 04/29/2021
Signature of Reporting Person Date
/s/ Frank Kung, as a managing member of Vivo Capital VIII, LLC, General Partner of Vivo Capital Fund VIII, L.P. 04/29/2021
Signature of Reporting Person Date
/s/ Frank Kung, as a managing member of Vivo Capital VIII, LLC, General Partner of Vivo Capital Surplus Fund VIII, L.P. 04/29/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Each share of Series C-1, C-2, C-3 and D Redeemable Convertible Preferred Stock is automatically converted into shares of Common Stock upon the closing of the Issuer's initial public offering for no additional consideration, on a one share of common stock for 16.37332 preferred shares basis.
( 2 )The convertible promissory note was issued by the issuer on March 5, 2021 and the outstanding principal and accrued interest is automatically converted into shares of the Issuer's Common Stock upon the closing of the Issuer's initial public offering at $13.50 per share (90% of the IPO price).
( 3 )The securities reported herein are held of record by Vivo Capital Fund VIII, L.P. Vivo Capital VIII, LLC is the general partner of Vivo Capital Fund VIII, L.P. As the managing members of Vivo Capital VIII, LLC, Frank Kung, Edgar Engleman and Shan Fu share voting and dispositive power over the shares held by Vivo Capital Fund VIII, L.P., but each disclaims beneficial ownership of such shares except to the extent of their individual pecuniary interest therein.
( 4 )The securities reported herein are held of record by Vivo Capital Surplus Fund VIII, L.P. Vivo Capital VIII, LLC is the general partner of Vivo Capital Surplus Fund VIII, L.P. As the managing members of Vivo Capital VIII, LLC, Frank Kung, Edgar Engleman and Shan Fu share voting and dispositive power over the shares held by Vivo Capital Surplus Fund VIII, L.P., but each disclaims beneficial ownership of such shares except to the extent of their individual pecuniary interest therein.

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