Statement of Changes in Beneficial Ownership (4)
February 11 2016 - 4:31PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Troendle August J.
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2. Issuer Name
and
Ticker or Trading Symbol
Coherus BioSciences, Inc.
[
CHRS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
C/O COHERUS BIOSCIENCES, INC., 333 TWIN DOLPHIN DRIVE, SUITE 600
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3. Date of Earliest Transaction
(MM/DD/YYYY)
2/9/2016
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(Street)
REDWOOD CITY, CA 94065
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock, $0.0001 par value
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2/9/2016
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M
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8124
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A
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$0.4168
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29994
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D
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Common Stock, $0.0001 par value
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1642492
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I
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See Footnote
(1)
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Common Stock, $0.0001 par value
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268428
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I
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See Footnote
(2)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(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)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Stock Option (Right to Buy)
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$0.4168
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2/9/2016
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M
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8124
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(3)
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7/17/2021
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Common Stock
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8124
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$0.00
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0
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D
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Explanation of Responses:
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(
1)
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The shares are held by MX II Associates LLC ("MX II Associates"). Reporting Person is the Managing Member of MX II Associates. Voting and dispositive decisions with respect to shares held by MX II Associates are made by Reporting Person, however, Reporting Person disclaims beneficial ownership of the shares held by MX II Associates, except to the extent of any pecuniary interest therein.
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(
2)
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The shares are held by Medpace Investors, LLC ("Medpace Investors"). Reporting Person is the Manager of Medpace Investors. Voting and dispositive decisions with respect to shares held by Medpace Investors are made by Reporting Person, however, Reporting Person disclaims beneficial ownership of the shares held by Medpace Investors, except to the extent of any pecuniary interest therein.
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(
3)
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The underlying shares subject to the option are fully vested as of the date of exercise.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Troendle August J.
C/O COHERUS BIOSCIENCES, INC.
333 TWIN DOLPHIN DRIVE, SUITE 600
REDWOOD CITY, CA 94065
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X
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Signatures
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/s/ Jean Frederic Viret, as Attorney-in-Fact for August J. Troendle
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2/11/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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