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) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series A Convertible Preferred Stock
|
Â
(2)
|
Â
(2)
|
Common Stock
|
21,053
(2)
|
$
(2)
|
I
|
By W. T. Green, Jr. Family Limited Partnership
|
Series B Convertible Preferred Stock
|
Â
(3)
|
Â
(3)
|
Common Stock
|
222,595
(3)
|
$
(3)
|
D
|
Â
|
Employee Stock Option (right to buy)
|
Â
(4)
|
08/01/2012 |
Common Stock
|
144,851
|
$
4.75
|
D
|
Â
|
Employee Stock Option (right to buy)
|
Â
(4)
|
08/01/2012 |
Common Stock
|
625
|
$
6
|
I
|
By Spouse
|
Employee Stock Option (right to buy)
|
Â
(4)
|
07/01/2013 |
Common Stock
|
500
|
$
6
|
I
|
By Spouse
|
Employee Stock Option (right to buy)
|
Â
(4)
|
06/30/2014 |
Common Stock
|
250
|
$
6
|
I
|
By Spouse
|
Employee Stock Option (right to buy)
|
Â
(4)
|
08/18/2015 |
Common Stock
|
58,912
|
$
4.75
|
D
|
Â
|
Employee Stock Option (right to buy)
|
Â
(4)
|
10/18/2017 |
Common Stock
|
70,505
|
$
4.75
|
D
|
Â
|
Employee Stock Option (right to buy)
|
Â
(4)
|
09/18/2018 |
Common Stock
|
7,766
|
$
4.75
|
D
|
Â
|
Employee Stock Option (right to buy)
|
Â
(4)
|
09/15/2019 |
Common Stock
|
500
|
$
5.19
|
D
|
Â
|
Employee Stock Option (right to buy)
|
Â
(5)
|
11/04/2019 |
Common Stock
|
33,750
|
$
5.19
|
D
|
Â
|
Employee Stock Option (right to buy)
|
Â
(6)
|
10/18/2020 |
Common Stock
|
16,875
|
$
6.92
|
D
|
Â
|
Employee Stock Option (right to buy)
|
Â
(7)
|
07/14/2021 |
Common Stock
|
16,875
|
$
13.31
|
D
|
Â
|
* |
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 reporting person serves as custodian for the benefit of his son for 18,259 shares. |
(2) |
Each share of Series A Convertible Preferred Stock will automatically convert into 1.263 shares of common stock in connection with the completion of the Company's initial public offering and has no expiration date. |
(3) |
Each share of Series B Convertible Preferred Stock will automatically convert into one share of common stock in connection with the completion of the Company's initial public offering and has no expiration date. |
(4) |
All options to purchase shares of common stock are currently exercisable. |
(5) |
The option vests over four years, with 25% vesting on November 4, 2010 and the remainder vesting over three years thereafter in monthly installments. |
(6) |
The option vests over four years, with 25% vesting on August 4, 2011 and the remainder vesting over three years thereafter in monthly installments. |
(7) |
The option vests over four years, with 25% vesting on July 14, 2012 and the remainder vesting over three years thereafter in monthly installments. |