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*
Richards Christos

(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 X 26,505 A $1.667 26,505 D
Common Stock, $0.0001 par value 11/12/2014 J(1) 2,956 D (1) 23,549 D
Common Stock, $0.0001 par value 11/12/2014 C 39,991 A (2) 63,540 D
Common Stock, $0.0001 par value 11/12/2014 C 12,672 A (2) 76,212 D
Common Stock, $0.0001 par value 11/12/2014 C 2,624 A (2) 78,836 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 Common Stock $1.667 11/12/2014 X 26,505 (3) (4) Common Stock 26,505 $0.00 0 D
Warrant to Purchase Series B Preferred Stock $0.0167 11/12/2014 X 429 (3) (4) Series B Preferred Stock 429 $0.00 0 D
Series B Preferred Stock (2) 11/12/2014 X 429 (2) (5) Common Stock 429 $0.0167 12,673 D
Series B Preferred Stock (2) 11/12/2014 J(6) 1 (2) (5) Common Stock 1 (2) 12,672 D
Series A Preferred Stock (2) 11/12/2014 C 39,991 (2) (5) Common Stock 39,991 (2) 0 D
Series B Preferred Stock (2) 11/12/2014 C 12,672 (2) (5) Common Stock 12,672 (2) 0 D
Series C Preferred Stock (2) 11/12/2014 C 2,624 (2) (5) Common Stock 2,624 (2) 0 D
Explanation of Responses:
1. Immediately prior to the closing of the IPO, the warrant automatically net exercised by its terms into Common Stock, which allowed the holder to pay the exercise price of the warrant by forfeiting a portion of the exercised warrant shares with a value equal to the aggregate exercise price.
2. 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.
3. The warrant is immediately exercisable.
4. The warrant expires upon the consummation of the Issuer's initial public offering to the extent not previously exercised.
5. The Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock have no expiration date.
6. Immediately prior to the closing of the IPO, the warrant automatically net exercised by its terms into Series B Preferred Stock, which allowed the holder to pay the exercise price of the warrant by forfeiting a portion of the exercised warrant shares with a value equal to the aggregate exercise price.
Remarks:
/s/ Matthew R. Hooper, as Attorney in Fact for Christos Richards 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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