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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)
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4. Transaction Code
(Instr. 8)
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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)
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7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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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 Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
107,604 |
(
1
) |
(
1
) |
Common Stock |
860,832 (
1
) |
$
0 |
0 |
I |
By SMC Growth Capital Partners II, LP (
2
) |
Series A-2 Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
39,726 |
(
1
) |
(
1
) |
Common Stock |
317,808 (
1
) |
$
0 |
0 |
I |
By SMC Growth Capital Partners II, LP (
2
) |
Series A-2 Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
87,398 |
(
1
) |
(
1
) |
Common Stock |
699,184 (
1
) |
$
0 |
0 |
I |
By SMC Private Equity Holdings, LP (
3
) |
Series A-2 Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
7,945 |
(
1
) |
(
1
) |
Common Stock |
63,560 (
1
) |
$
0 |
0 |
I |
By SMC Holdings II, LP (
4
) |
Series B Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
73,571 |
(
1
) |
(
1
) |
Common Stock |
588,568 (
1
) |
$
0 |
0 |
I |
By SMC Growth Capital Partners II, LP (
2
) |
Series B Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
53,480 |
(
1
) |
(
1
) |
Common Stock |
427,840 (
1
) |
$
0 |
0 |
I |
By SMC Private Equity Holdings, LP (
3
) |
Series B-2 Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
84,347 |
(
1
) |
(
1
) |
Common Stock |
674,776 (
1
) |
$
0 |
0 |
I |
By SMC Growth Capital Partners II, LP (
2
) |
Series B-2 Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
47,403 |
(
1
) |
(
1
) |
Common Stock |
379,224 (
1
) |
$
0 |
0 |
I |
By SMC Private Equity Holdings, LP (
3
) |
Series C Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
78,999 |
(
1
) |
(
1
) |
Common Stock |
631,992 (
1
) |
$
0 |
0 |
I |
By SMC Growth Capital Partners II, LP (
2
) |
Series C Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
24,833 |
(
1
) |
(
1
) |
Common Stock |
198,664 (
1
) |
$
0 |
0 |
I |
By SMC Private Equity Holdings, LP (
3
) |
Series C-2 Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
51,522 |
(
1
) |
(
1
) |
Common Stock |
412,176 (
1
) |
$
0 |
0 |
I |
By SMC Growth Capital Partners II, LP (
2
) |
Series C-2 Redeemable Convertible Preferred Stock |
(
1
) |
10/12/2021 |
|
C |
|
|
51,522 |
(
1
) |
(
1
) |
Common Stock |
412,176 (
1
) |
$
0 |
0 |
I |
By SMC Private Equity Holdings, LP (
3
) |
|
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Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,