Statement of Changes in Beneficial Ownership (4)
January 23 2018 - 5:50PM
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
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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
*
Weber David Allen
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2. Issuer Name
and
Ticker or Trading Symbol
OTONOMY, INC.
[
OTIC
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President & CEO
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(Last)
(First)
(Middle)
C/O OTONOMY, INC., 4796 EXECUTIVE DRIVE
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3. Date of Earliest Transaction
(MM/DD/YYYY)
1/19/2018
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(Street)
SAN DIEGO, CA 92121
(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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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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Employee Stock Option (right to buy)
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$34.12
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1/19/2018
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D
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130000
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(1)
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12/10/2024
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Common Stock
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130000
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(2)
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0
(3)
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D
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Employee Stock Option (right to buy)
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$14.44
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1/19/2018
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D
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230000
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(4)
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2/28/2026
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Common Stock
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230000
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(5)
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0
(3)
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D
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Employee Stock Option (right to buy)
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$14.00
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1/19/2018
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D
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200000
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(6)
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3/5/2027
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Common Stock
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200000
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(7)
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0
(3)
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D
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Employee Stock Option (right to buy)
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$5.675
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1/19/2018
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A
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86666
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(8)
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1/18/2026
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Common Stock
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86666
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(2)
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86666
(3)
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D
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Employee Stock Option (right to buy)
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$5.675
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1/19/2018
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A
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153333
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(9)
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1/18/2026
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Common Stock
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153333
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(5)
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153333
(3)
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D
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Employee Stock Option (right to buy)
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$5.675
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1/19/2018
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A
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133333
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(10)
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1/18/2026
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Common Stock
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133333
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(7)
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133333
(3)
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D
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Explanation of Responses:
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(1)
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One-fourth (1/4) of the shares subject to the option vest on December 11, 2015 and one forty-eighth (1/48) of the shares vest monthly thereafter.
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(2)
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On January 19, 2018, in connection with the Issuer's option exchange program, the Issuer cancelled an option for 130,000 shares of common stock granted to the Reporting Person on December 11, 2014. In exchange, the Reporting Person received an option grant for 86,666 shares of common stock with exercise price of $5.675 per share.
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(3)
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In addition to the options acquired and disposed of as set forth in Table II, the Reporting Person currently holds options to purchase up to an
aggregate of 785,730 shares of common stock, which options vest according to their terms.
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(4)
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One-fourth (1/4) of the shares subject to the option vest on March 1, 2017 and one forty-eighth (1/48) of the shares vest monthly thereafter.
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(5)
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On January 19, 2018, in connection with the Issuer's option exchange program, the Issuer cancelled an option for 230,000 shares of common stock granted to the Reporting Person on March 1, 2016. In exchange, the Reporting Person received an option grant for 153,333 shares of common stock with exercise price of $5.675 per share.
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(6)
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One-fourth (1/4) of the shares subject to the option vest on March 6, 2018 and one forty-eighth (1/48) of the shares vest monthly thereafter.
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(7)
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On January 19, 2018, in connection with the Issuer's option exchange program, the Issuer cancelled an option for 200,000 shares of common stock granted to the Reporting Person on March 6, 2017. In exchange, the Reporting Person received an option grant for 133,333 shares of common stock with exercise price of $5.675 per share.
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(8)
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Of the 86,666 total shares subject to the option, 77,638 shares vest on January 19, 2019. Of the remaining 9,028 shares subject to the option, one-third
(1/3) of these shares vest on January 19, 2019, and one thirty-sixth (1/36) of these shares vest monthly thereafter.
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(9)
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Of the 153,333 total shares subject to the option, 89,444 shares vest on January 19, 2019. Of the remaining 63,889 shares subject to the option, one-third (1/3) of these shares vest on January 19, 2019, and one thirty-sixth (1/36) of these shares vest monthly thereafter.
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(10)
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Of the 133,333 total shares subject to the option, 44,444 shares vest on January 19, 2019. Of the remaining 88,889 shares subject to the option, one-third (1/3) of these shares vest on January 19, 2019, and one thirty-sixth (1/36) of these shares vest monthly thereafter.
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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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Weber David Allen
C/O OTONOMY, INC.
4796 EXECUTIVE DRIVE
SAN DIEGO, CA 92121
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X
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President & CEO
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Signatures
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/s/ Paul E. Cayer, by power of attorney
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1/23/2018
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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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