| 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) 10/21/2010 |
3. Issuer Name and Ticker or Trading Symbol
Aegerion Pharmaceuticals, Inc. [ AEGR ] |
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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 A Convertible Preferred Stock | (1) | (2) | Common Stock | 1,086,336 | (2) | D(3)(4) | |
| Series A Convertible Preferred Stock | (1) | (2) | Common Stock | 72,957 | (2) | D(4)(5) | |
| Series A Convertible Preferred Stock | (1) | (2) | Common Stock | 26,771 | (2) | D(4)(6) | |
| Series B Convertible Preferred Stock | (1) | (2) | Common Stock | 379,545 | (2) | D(3)(4) | |
| Series B Convertible Preferred Stock | (1) | (2) | Common Stock | 25,490 | (2) | D(4)(5) | |
| Series B Convertible Preferred Stock | (1) | (2) | Common Stock | 9,353 | (2) | D(4)(6) | |
| Senior Subordinated Convertible Promissory Notes | (7) | 12/31/2011 | Common Stock | 700,050 | 7.6(8) | D(3)(4) | |
| Senior Subordinated Convertible Promissory Notes | (9) | 12/31/2011 | Common Stock | 47,010 | 7.6(8) | D(4)(5) | |
| Senior Subordinated Convertible Promissory Notes | (10) | 12/31/2011 | Common Stock | 17,250 | 7.6(8) | D(4)(6) | |
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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1. Name and Address of Reporting Person*
(Street)
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| Explanation of Responses: |
| 1. The Series A Convertible Preferred Shares (the "Series A Shares") were issued on December 16, 2005 and the Series B Convertible Preferred Shares (the "Series B Shares") were issued on November 13, 2007. Each of the Series A shares and Series B shares are convertible, in accordance with the Issuer's Third Amended and Restated Certificate of Incorporation, at any time after the issuance of such share, at the holder's election. |
| 2. The Series A Shares and the Series B Shares will convert automatically into Common Stock, without the payment of additional consideration, upon the closing of the Issuer's initial public offering and do not have an expiration date. The Series A Shares will convert on a 1-for-0.38701117412 basis and the Series B Shares will convert on a 1-for-0.61027657931 basis. |
| 3. These securities are beneficially owned by Alta BioPharma Partners III, L.P. ("ABPIII"). |
| 4. Alta BioPharma Management III, LLC ("ABMIII") is the general partner of ABPIII and the managing limited partner of Alta BioPharma Partners III GmbH & Co. Beteiligungs KG ("ABPIIIKG"). Jean Deleage, Farah Champsi, Edward Penhoet and Edward Hurwitz are the directors of ABMIII and managers of Alta Embarcadero BioPharma Partners III, LLC ("AEBPIII"). Alison Kiley, a director of the Issuer, is a member of ABMIII and may be deemed to share investment power over the securities of the Issuer held by ABPIII, ABPIIIKG and AEBPIII with the directors of ABMIII and managers of AEBPIII. Mr. Deleage, Ms. Champsi, Mr. Penhoet, Mr. Hurwitz, and Ms. Kiley disclaim beneficial ownership of such securities except to the extent of his or her pecuniary interest therein |
| 5. These securities are beneficially owned by ABPIIIKG. |
| 6. These securities are beneficially owned by AEBPIII. |
| 7. Reflects $4,823,353.04 aggregate principal amount of the Issuer's senior subordinated convertible promissory notes (the "Convertible Notes") held by ABPIII, dated September 2, 2008, December 11, 2008, July 2, 2009, January 28, 2010, June 14, 2010, August 13, 2010, and October 1, 2010. The outstanding principal and accrued and unpaid interest on these Convertible Notes are automatically convertible into shares of common stock upon the closing of the Issuer's initial public offering. |
| 8. The outstanding principal and accrued and unpaid interest on the Convertible Notes shall automatically be converted into shares of common stock upon the closing of the Issuer's initial public offering at $7.60 per share, 80% of the initial public offering price per share. |
| 9. Reflects $323,930.29 aggregate principal amount of Convertible Notes held by ABPIIIKG, dated September 2, 2008, December 11, 2008, July 2, 2009, January 28, 2010, June 14, 2010, August 13, 2010, and October 1, 2010. The outstanding principal and accrued and unpaid interest on these Convertible Notes are automatically convertible into shares of common stock upon the closing of the Issuer's initial public offering. |
| 10. Reflects $118,867.78 aggregate principal amount of Convertible Notes held by AEBPIII, dated September 2, 2008, December 11, 2008, July 2, 2009, January 28, 2010, June 14, 2010, August 13, 2010, and October 1, 2010. The outstanding principal and accrued and unpaid interest on these Convertible Notes are automatically convertible into shares of common stock upon the closing of the Issuer's initial public offering. |
| Remarks: |
| By Alta BioPharma Management III, LLC /s/ Jean Deleage, Director | 10/21/2010 | |
| /s/ Jean Deleage, Director | 10/21/2010 | |
| By Alta BioPharma Management III, LLC, /s/ Jean Deleage, Director | 10/21/2010 | |
| /s/ Jean Deleage, Manager | 10/21/2010 | |
| /s/ Farah Champsi | 10/21/2010 | |
| /s/ Jean Deleage | 10/21/2010 | |
| /s/ Edward Hurwitz | 10/21/2010 | |
| /s/ Edward Penhoet | 10/21/2010 | |
| ** 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. | ||