| FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 07/08/2004 |
3. Issuer Name and Ticker or Trading Symbol
NETLOGIC MICROSYSTEMS INC [ NETL ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
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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 Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Series C Preferred Stock | (1) | (1) | COMMON STOCK | 999,200 | 0 | I | SEE FOOTNOTE(3) |
| Series D Preferred Stock | (1) | (1) | COMMON STOCK | 384,615 | 0 | I | SEE FOOTNOTE(4) |
| Warrants | (2) | (2) | COMMON STOCK | 20,000 | 2 | I | SEE FOOTNOTE(5) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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| Explanation of Responses: |
| 1. Each share of Series C Preferred Stock and Series D Preferred Stock may be converted at anytime into common stock on a 1-for-1 basis; automatically converts at the closing of an initial public offering. |
| 2. The Warrant becomes exercisable from and after the first anniversary of the date of issuance, the "Commencement Date" and shall expire and no longer be exercisable on or after the earliest of (i) 5:00 p.m. San Francisco, California local time, on the date that is three (3) years after the Commencement Date, (ii) the closing of a Qualified Offering, or (iii) the closing date of a Change of Control Transaction. Notwithstanding the foregoing, if either of the events described in clause (ii) or (iii) shall occur prior to the Commencement Date, the Warrant shall become exercisable, subject to the consummation of such event, from and after the date that the holder receives notice of such event pursuant to the terms of the Warrant, and shall expire and no longer be exercisable on or after the closing date of such event. |
| 3. Total common shares of 999,200, represents 979,216 of such common shares held by Sevin Rosen Fund VIII L.P. ("SRFVIII") and 19,984 of such common shares held by Sevin Rosen VIII Affiliates Fund L.P. ("SRFVIII AFF"). Stephen M. Dow ("Dow), Jon W. Bayless ("Bayless"), John V. Jaggers ("Jaggers"), Charles H. Phipps ("Phipps"), Jackie R. Kimzey ("Kimzey"), David A. Shrigley ("Shrigley") and Alan R. Schuele ("Schuele") are general partners of the general partner of SRF VIII and SRFVIII AFF. Messers. Dow, Bayless, Jaggers, Phipps, Kimzey, Shrigley and Schuele disclaim beneficial ownership of these shares except to the extent of his proportionate partnership interest in these shares. |
| 4. Total common shares of 384,615, represents 376,923 of such common shares held by SRFVIII and 7,692 of such common shares held by SRFVIII AFF. Dow, Bayless, Jaggers, Phipps, Kimzey, Shrigley and Schuele are general partners of the general partner of SRF VIII and SRFVIII AFF. Messers. Dow, Bayless, Jaggers, Phipps, Kimzey, Shrigley and Schuele disclaim beneficial ownership of these shares except to the extent of his proportionate partnership interest in these shares. |
| 5. Total common shares of 20,000, represents 19,600 of such common shares held by SRFVIII and 400 such common shares held by SRFVIII AFF. Dow, Bayless, Jaggers, Phipps, Kimzey, Shrigley and Schuele are general partners of the general partner of SRF VIII and SRFVIII AFF. Messers. Dow, Bayless, Jaggers, Phipps, Kimzey, Shrigley and Schuele disclaim beneficial ownership of these shares except to the extent of his proportionate partnership interest in these shares. |
| John V. Jaggers, By Power Of Attorney | 07/08/2004 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
| ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| 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 Number. | ||