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*
Lanfear Dennis M

(Last) (First) (Middle)
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
X Officer (give title below) Other (specify below)
See Remarks
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 17,734 A (1) 68,723 D
Common Stock, $0.0001 par value 11/12/2014 C 3,193 A (1) 1,361,921 I By Trust(2)
Common Stock, $0.0001 par value 11/12/2014 C 60,135 A (1) 60,135 I By LLC(3)
Common Stock, $0.0001 par value 11/12/2014 C 21,527 A (1) 81,662 I By LLC(3)
Common Stock, $0.0001 par value 11/12/2014 C 5,286 A (1) 86,948 I By LLC(3)
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 A Preferred Stock $1.2503 11/12/2014 X 19,976 (4) (5) Series A Preferred Stock 19,976 $0.00 0 I By LLC(3)
Series A Preferred Stock (1) 11/12/2014 X 19,976 (1) (6) Common Stock 19,976 $1.2503 60,135 I By LLC(3)
Warrant to Purchase Series B Preferred Stock $0.0167 11/12/2014 X 3,225 (4) (5) Series B Preferred Stock 3,225 $0.00 0 D
Series B Preferred Stock (1) 11/12/2014 X 3,225 (1) (6) Common Stock 3,225 $0.0167 17,734 D
Series B Preferred Stock (1) 11/12/2014 C 17,734 (1) (6) Common Stock 17,734 (1) 0 D
Series B Preferred Stock (1) 11/12/2014 C 3,193 (1) (6) Common Stock 3,193 (1) 0 I By Trust(2)
Series A Preferred Stock (1) 11/12/2014 C 60,135 (1) (6) Common Stock 60,135 (1) 0 I By LLC(3)
Series B Preferred Stock (1) 11/12/2014 C 21,527 (1) (6) Common Stock 21,527 (1) 0 I By LLC(3)
Series C Preferred Stock (1) 11/12/2014 C 5,286 (1) (6) Common Stock 5,286 (1) 0 I By LLC(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. These shares are held by the Lanfear Revocable Trust, dated January 27, 2004, as restated, of which Reporting Person is a trustee.
3. These shares are held by Lanfear Capital Advisors, LLC of which Reporting Person is President.
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:
President and Chief Executive Officer
/s/ Matthew R. Hooper, as Attorney-in-Fact for Dennis M. Lanfear 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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