FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/30/2007 |
3. Issuer Name and Ticker or Trading Symbol
AMICUS THERAPEUTICS INC [ FOLD ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 988,446(1) | 0(1) | I | Frazier Healthcare IV, L.P.(2) |
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 5,016(1) | 0(1) | I | Frazier Affiliates IV, L.P.(2) |
Series C Convertible Preferred Stock | (1) | (1) | Common Stock | 1,011,088(1) | 0(1) | I | Frazier Healthcare IV, L.P.(2) |
Series C Convertible Preferred Stock | (1) | (1) | Common Stock | 5,132(1) | 0(1) | I | Frazier Affiliates, IV, L.P.(2) |
Series D Convertible Preferred Stock | (1) | (1) | Common Stock | 572,310(1) | 0(1) | I | Frazier Healthcare IV, L.P.(2) |
Series D Convertible Preferred Stock | (1) | (1) | Common Stock | 2,904(1) | 0(1) | I | Frazier Affiliates IV, L.P.(2) |
Series B Convertible Preferred Stock Warrant (right to buy) | (3) | (3) | Series B Convertible Preferred Stock | 15,042 | 6.375 | I | Frazier Healthcare IV, L.P.(2) |
Series B Convertible Preferred Stock Warrant (right to buy) | (3) | (3) | Series B Convertible Preferred Stock | 76 | 6.375 | I | Frazier Affiliates IV, L.P.(2) |
Explanation of Responses: |
1. Each share is convertible and will automatically convert on a 1-for-1 basis into the Issuer's common stock upon the closing of the Issuer's initial public offering of common stock pursuant to an effecive registration statement filed with the U.S. Securities and Exchange Commission. These shares have no expiration date. |
2. The securities are owned directly by the entity listed. The reporting person is a limited partner of FHM IV, LP, the general partner of Frazier Healthcare IV, LP and Frazier Affiliates IV, LP. Voting and investment power over such shares is exercised by FHM IV, LLC in its role as the general partner of FHM IV, LP. The reporting person disclaims beneficial ownership of these shares except to the extent of his proportionate pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of the shares for purposes of Section 16 or for any other purpose. |
3. The warrants to purchase Series B convertible preferred stock will automatically be exercised for cash immediately prior to the closing of the Issuer's initial public offering. |
James N. Topper | 05/30/2007 | |
** 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 5 (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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |