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Share Name | Share Symbol | Market | Type |
---|---|---|---|
AcelRX Pharmaceuticals Inc | NASDAQ:ACRX | NASDAQ | Common Stock |
Price Change | % Change | Share Price | Bid Price | Offer Price | High Price | Low Price | Open Price | Shares Traded | Last Trade | |
---|---|---|---|---|---|---|---|---|---|---|
0.00 | 0.00% | 0.86 | 0.861 | 0.89 | 0 | 01:00:00 |
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
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OMB APPROVAL
OMB Number: 3235-0287 Estimated average burden hours per response... 0.5 |
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1. Name and Address of Reporting Person
*
WAN MARK A |
2. Issuer Name
and
Ticker or Trading Symbol
ACELRX PHARMACEUTICALS INC [ ACRX ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__ X __ Director __ X __ 10% Owner _____ Officer (give title below) _____ Other (specify below) |
3200 ALPINE ROAD |
3. Date of Earliest Transaction
(MM/DD/YYYY)
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PORTOLA VALLEY, CA 94028 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person _ X _ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1.Title of Security
(Instr. 3) |
2. Trans. Date | 2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 12/7/2012 | P | 2364705 | A | $3.31 | 6323534 | I | See Footnote (3) | ||
Common Stock | 12/7/2012 | P | 52213 | A | $3.31 | 139621 | I | See Footnote (4) | ||
Common Stock | 3704712 | I | See Footnote (1) | |||||||
Common Stock | 199174 | I | See Footnote (2) |
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) |
2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: | |
( 1) | The shares are held by Three Arch Partners III, L.P. ("TAP III"). Three Arch Management III, L.L.C. ("TAM III"), the general partner of TAP III, has sole voting and dispositive power with respect to the securities held by TAP III. Mark A. Wan and Wilfred Jaeger, the managing members of TAM III, share the voting and dispositive power with respect to the shares hld by TAP III. Such persons and entities disclaim beneficial ownership of the shares held by TAP III except to the extent of any pecuniary interest therein. |
( 2) | The shares are held by Three Arch Associates III, L.P. ("TAA III"). TAM III, the general partner of TAA III, has sole voting and dispositive power with respect to the securities held by TAA III. Mark A. Wan and Wilfred Jaeger, the managing members of TAM III, share the voting and dispositive power with respect to the shares hld by TAA III. Such persons and entities disclaim beneficial ownership of the shares held by TAA III except to the extent of any pecuniary interest therein. |
( 3) | The shares are held by Three Arch Partners IV, L.P. ("TAP IV"). Three Arch Management IV, L.L.C. ("TAM IV"), the general partner of TAP IV, has sole voting and dispositive power with respect to the securities held by TAP IV. Mark A. Wan and Wilfred Jaeger, the managing members of TAM IV, share the voting and dispositive power with respect to the shares hld by TAP IV. Such persons and entities disclaim beneficial ownership of the shares held by TAP IV except to the extent of any pecuniary interest therein. |
( 4) | The shares are held by Three Arch Associates IV, L.P. ("TAA IV"). TAM IV, the general partner of TAA IV, has sole voting and dispositive power with respect to the securities held by TAA IV. Mark A. Wan and Wilfred Jaeger, the managing members of TAM IV, share the voting and dispositive power with respect to the shares hld by TAA IV. Such persons and entities disclaim beneficial ownership of the shares held by TAA IV except to the extent of any pecuniary interest therein. |
Reporting Owners
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Reporting Owner Name / Address |
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Director | 10% Owner | Officer | Other | ||
WAN MARK A
3200 ALPINE ROAD PORTOLA VALLEY, CA 94028 |
X | X |
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JAEGER WILFRED E
3200 ALPINE DRIVE PORTOLA VALLEY, CA 94028 |
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X |
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THREE ARCH PARTNERS III LP
3200 ALPINE DRIVE PORTOLA VALLEY, CA 94028 |
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X |
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THREE ARCH ASSOCIATES III LP
3200 ALPINE ROAD PORTOLA VALLEY, CA 94028 |
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X |
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THREE ARCH PARTNERS IV LP
3200 ALPINE ROAD PORTOLA VALLEY, CA 94028 |
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X |
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THREE ARCH ASSOCIATES IV LP
3200 ALPINE ROAD PORTOLA VALLEY, CA 94028 |
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X |
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Signatures
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/s/ Steve Agelopoulos, Attorney-in-Fact for Mark A. Wan | 12/7/2012 | |
** Signature of Reporting Person |
Date
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/s/ Steve Agelopoulos, Attorney-in-Fact for Wilf Jaeger | 12/7/2012 | |
** Signature of Reporting Person |
Date
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/s/ Steve Agelopoulos, Attorney-in-Fact for the GP of Three Arch Partners IV, L.P. | 12/7/2012 | |
** Signature of Reporting Person |
Date
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/s/ Steve Agelopoulos, Attorney-in-Fact for the GP of Three Arch Partners III, L.P. | 12/7/2012 | |
** Signature of Reporting Person |
Date
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/s/ Steve Agelopoulos, Attorney-in-Fact for the GP of Three Arch Associates IV, L.P. | 12/7/2012 | |
** Signature of Reporting Person |
Date
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/s/ Steve Agelopoulos, Attorney-in-Fact for the GP of Three Arch Associates III, L.P. | 12/7/2012 | |
** Signature of Reporting Person |
Date
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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 4(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 control number. |
1 Year AcelRX Pharmaceuticals Chart |
1 Month AcelRX Pharmaceuticals Chart |
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