SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Troendle August J.

(Last) (First) (Middle)
C/O COHERUS BIOSCIENCES, INC.
201 REDWOOD SHORES PARKWAY, SUITE 200

(Street)
REDWOOD CITY CA 94065

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Coherus BioSciences, Inc. [ CHRS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
11/12/2014
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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, $0.0001 par value 11/12/2014 C 319,935 A (1) 319,935 I See Footnote(2)
Common Stock, $0.0001 par value 11/12/2014 C 1,556,055 A (1) 1,875,990 I See Footnote(2)
Common Stock, $0.0001 par value 11/12/2014 C 266,502 A (1) 2,142,492 I See Footnote(2)
Common Stock, $0.0001 par value 11/12/2014 C 358,428 A (1) 358,428 I See Footnote(3)
Common Stock, $0.0001 par value 21,870 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: 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
Warrant to Purchase Series B Preferred Stock $0.0167 11/12/2014 X 107,528 (4) (5) Series B Preferred Stock 107,528 $0.00 0 I See Footnote(2)
Series B Preferred Stock (1) 11/12/2014 X 107,528 (1) (6) Common Stock 107,528 $0.0167 1,556,055 I See Footnote(2)
Series A Preferred Stock (1) 11/12/2014 C 319,935 (1) (6) Common Stock 319,935 (1) 0 I See Footnote(2)
Series B Preferred Stock (1) 11/12/2014 C 1,556,055 (1) (6) Common Stock 1,556,055 (1) 0 I See Footnote(2)
Series C Preferred Stock (1) 11/12/2014 C 266,502 (1) (6) Common Stock 266,502 (1) 0 I See Footnote(2)
Series B Preferred Stock (1) 11/12/2014 C 358,428 (1) (6) Common Stock 358,428 (1) 0 I See Footnote(3)
Explanation of Responses:
1. The Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock automatically converted into shares of Issuer's Common Stock on a 1 for 1 basis upon the closing of Issuer's initial public offering.
2. The shares are held by MX II Associates LLC ("MX II Associates"). Reporting Person is the Managing Member of MX II Associates. Voting and dispositive decisions with respect to shares held by MX II Associates are made by Reporting Person, however, Reporting Person disclaims beneficial ownership of the shares held by MX II Associates, except to the extent of any pecuniary interest therein.
3. The shares are held by Medpace Investors, LLC ("Medpace Investors"). Reporting Person is the Manager of Medpace Investors. Voting and dispositive decisions with respect to shares held by Medpace Investors are made by Reporting Person, however, Reporting Person disclaims beneficial ownership of the shares held by Medpace Investors, except to the extent of any pecuniary interest therein.
4. The warrant is immediately exercisable.
5. The warrant expires upon the consummation of the Issuer's initial public offering to the extent not previously exercised.
6. The Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock have no expiration date.
Remarks:
/s/ Matthew R. Hooper, as Attorney in Fact for August J. Troendle 11/12/2014
** 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 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).
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