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*
HEALY JAMES

(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 47 A (1) 47 D
Common Stock, $0.0001 par value 11/12/2014 C 1,846,890 A (1) 1,981,863 I See Footnote(2)
Common Stock, $0.0001 par value 11/12/2014 C 149,970 A (1) 2,131,833 I See Footnote(2)
Common Stock, $0.0001 par value 11/12/2014 P 425,926(3) A $13.5 2,557,759 I See Footnote(2)
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
Series B Preferred Stock (1) 11/12/2014 C 47 (1) (4) Common Stock 47 (1) 0 D
Series B Preferred Stock (1) 11/12/2014 C 1,846,890 (1) (4) Common Stock 1,846,890 (1) 0 I See Footnote(2)
Series C Preferred Stock (1) 11/12/2014 C 149,970 (1) (4) Common Stock 149,970 (1) 0 I See Footnote(2)
Explanation of Responses:
1. The 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 Reporting Person is one of the managing members of the general partner of Sofinnova Venture Partners VII, L.P. that directly holds the reported securities, and as such, may be deemed to share voting and investment power with respect to such securities. The Reporting Person disclaims beneficial ownership of the reported securities, except to the extent of his proportionate pecuniary interest in Sofinnova Ventures Partners VII, L.P.
3. Sofinnova Venture Partners VII, L.P. purchased an additional 425,926 shares of Issuer's Common Stock in connection with the IPO at the offering price of $13.50 per share.
4. The Series B Preferred Stock and Series C Preferred Stock have no expiration date.
Remarks:
/s/ Matthew R. Hooper, as Attorney-in-Fact for James I. Healy, M.D., Ph.D. 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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