UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Blumberg Capital II, L. P. 432 BRYANT STREET SAN FRANCISCO, CA 94105 |
X |
/s/ David J. Blumberg, Managing Member of Blumberg Capital Management II, L.L.C., the General Partner of the Reporting Person | 04/20/2021 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The shares are held directly by Blumberg Capital II, L.P. ("BC II"). Blumberg Capital Management II, L.L.C. ("BCM II") is the sole general partner of BC II. David J. Blumberg ("Blumberg" and, together with BC II and BCM II, the "Reporting Persons") is the managing director of BCM II. BCM II and Blumberg have voting and dispositive power over the shares held by BC II and may be deemed to beneficially own the shares held by BC II. Each of the Reporting Persons disclaims beneficial ownership of the shares reported herein except to the extent of his or its respective pecuniary interest therein. |