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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
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 Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Castle Creek Capital Partners V, LP C/O CASTLE CREEK CAPITAL LLC 6051 EL TORDO, PO BOX 1329 RANCHO SANTA FE, CA 92067 |
X | |||
Castle Creek Capital V LLC C/O CASTLE CREEK CAPITAL LLC 6051 EL TORDO, PO BOX 1329 RANCHO SANTA FE, CA 92067 |
X | |||
EGGEMEYER JOHN M III C/O CASTLE CREEK CAPITAL LLC 6051 EL TORDO, PO BOX 1329 RANCHO SANTA FE, CA 92067 |
X | |||
THOMAS J MIKESELL C/O CASTLE CREEK CAPITAL LLC 6051 EL TORDO, PO BOX 1329 RANCHO SANTA FE, CA 92067 |
X | |||
MERLO MARK G C/O CASTLE CREEK CAPITAL LLC 6051 EL TORDO, PO BOX 1329 RANCHO SANTA FE, CA 92067 |
X | |||
Pietrzak John C/O CASTLE CREEK CAPITAL LLC 6051 EL TORDO, PO BOX 1329 RANCHO SANTA FE, CA 92067 |
X |
CASTLE CREEK CAPITAL PARTNERS V, LP, By: /s/ John M. Eggemeyer, Name: John M. Eggemeyer, Title: President | 08/15/2017 | |
**Signature of Reporting Person | Date | |
CASTLE CREEK CAPITAL V LLC, By: /s/ John M. Eggemeyer, Name: John M. Eggemeyer, Title: President | 08/15/2017 | |
**Signature of Reporting Person | Date | |
JOHN M. EGGEMEYER, By: /s/ John M. Eggemeyer, Name: John M. Eggemeyer | 08/15/2017 | |
**Signature of Reporting Person | Date | |
J. MIKESELL THOMAS, By: /s/ J. Mikesell Thomas, Name: J. Mikesell Thomas | 08/15/2017 | |
**Signature of Reporting Person | Date | |
MARK G. MERLO, By: /s/ Mark G. Merlo, Name: Mark G. Merlo | 08/15/2017 | |
**Signature of Reporting Person | Date | |
JOHN T. PIETRZAK, By: /s/ John T. Pietrzak, Name: John T. Pietrzak | 08/15/2017 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | These securities are held directly by Castle Creek Capital Partners V, LP ("Fund V"). Mr. Eggemeyer, Mr. Thomas, Mr. Merlo, and Mr. Pietrzak are managing principals of Castle Creek Capital V LLC, the sole general partner of Fund V. Castle Creek Capital V LLC, Mr. Eggemeyer, Mr. Thomas, Mr. Merlo, and Mr. Pietrzak each disclaim beneficial ownership of such shares of Common Stock, except to the extent of their respective pecuniary interest therein, and this report shall not be deemed an admission that Castle Creek Capital V LLC, Mr. Eggemeyer, Mr. Thomas, Mr. Merlo, or Mr. Pietrzak is the beneficial owner of such shares of Common Stock for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose. |