SEC FORM
3
SEC Form 3
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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
C/O PROSPECT VENTURE PARTNERS |
435 TASSO STREET SUITE 200 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/30/2007
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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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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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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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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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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)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series B Convertible Preferred Stock |
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Common Stock |
978,562 |
0 |
I |
By Prospect Venture Partners II, L.P.
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Series B Convertible Preferred Stock |
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Common Stock |
14,902 |
0 |
I |
By Prospect Associates II,L.P.
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Series C Convertible Preferred Stock |
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Common Stock |
1,000,978 |
0 |
I |
By Prospect Venture Partners II, L.P.
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Series C Convertible Preferred Stock |
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Common Stock |
15,242 |
0 |
I |
By Prospect Associates II, L.P.
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Series D Convertible Preferred Stock |
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Common Stock |
219,042 |
0 |
I |
By Prospect Venture Partners II, L.P.
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Series D Convertible Preferred Stock |
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Common Stock |
3,334 |
0 |
I |
By Prospect Associates II, L.P.
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Warrants to purchase Series B Preferred Stock |
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Common Stock |
14,892 |
6.375 |
I |
By Prospect Venture Partners II, L.P.
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Warrants to purchase Series B Preferred Stock |
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Common Stock |
227 |
6.375 |
I |
By Prospect Associates II, L.P.
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1. Name and Address of Reporting Person*
C/O PROSPECT VENTURE PARTNERS |
435 TASSO STREET SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
C/O PROSPECT VENTURE PARTNERS |
435 TASSO STREET SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
C/O PROSPECT VENTURE PARTNERS |
435 TASSO STREET SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
C/O PROSPECT VENTURE PARTNERS |
435 TASSO STREET SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
C/O PROSPECT VENTURE PARTNERS |
435 TASSO STREET SUITE 200 |
(Street)
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1. Name and Address of Reporting Person*
C/O PROSPECT VENTURE PARTNERS |
435 TASSO STREET SUITE 200 |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Dave Markland, Attorney-in-Fact for Prospect Venture Partners II, L.P. |
05/30/2007 |
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/s/ Dave Markland, Attorney-in-Fact for Prospect Management Co. II, LLC |
05/30/2007 |
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/s/ Dave Markland, Attorney-in-Fact for Prospect Associates II, L.P. |
05/30/2007 |
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/s/ Dave Markland, Attorney-in-Fact for James B. Tananbaum |
05/30/2007 |
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/s/ Dave Markland, Attorney-in-Fact for Russell C. Hirsch |
05/30/2007 |
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/s/ Dave Markland, Attorney-in-Fact for David Schnell |
05/30/2007 |
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** 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. |
Exhibit 99
Exhibit 99
FORM 3 JOINT FILER INFORMATION
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Name of |
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Reporting Persons:
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Prospect Venture Partners II, L.P. (PVP II) |
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Prospect Associates II, L.P. (PA II) |
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Prospect Management Co. II, L.L.C. (PMC II) |
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James B. Tananbaum, M.D. |
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Russell C. Hirsch, M.D., Ph.D. |
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David Schnell, M.D. |
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Address:
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c/o Prospect Venture Partners |
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435 Tasso Street, Suite 200 |
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Palo Alto, California 94301 |
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Designated Filer:
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Prospect Venture Partners II, L.P. |
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Issuer and |
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Ticker Symbol:
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Amicus Therapeutics, Inc. (FOLD) |
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Date of Event:
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May 30, 2007 |
Each of the following is a Joint Filer with PVP II and shares voting and investment power over the
securities set forth on the attached Form 3:
PMC II serves as the general partner of PVP II and PA II. PMC II has sole voting and investment
control over the respective shares owned by PVP II and PA II. James B. Tananbaum, M.D., Russell C.
Hirsch, M.D., Ph.D. and David Schnell, M.D. are Managing Directors of PMC II and shares voting and
investment power over the shares owned by PVP II and PA II.
Each reporting person disclaims beneficial ownership of the shares reported herein, except to the
extent of his proportionate pecuniary interest therein. The filing of this statement shall not be
deemed an admission that, for purposes of Section 16 of the Securities Exchange Act of 1934, or
otherwise, any of the Reporting Persons are the beneficial owner of all of the equity securities
covered by this statement.
Each of the Reporting Persons listed above has designated Prospect Venture Partners II, L.P. as its
designated filer of Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities Exchange
Act of 1934 and the rules thereunder. Each Reporting Person has appointed Dave Markland as its
attorney-in-fact for the purpose of making reports relating to transactions in Amicus Therapeutics,
Inc. Common Stock.
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PROSPECT VENTURE PARTNERS II, L.P.
By Prospect Management Co. II, L.L.C.
Its General Partner
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By: |
/s/ Dave Markland, Attorney in Fact for |
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Name: |
Prospect Venture Partners II, L.P.
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Managing Director |
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PROSPECT ASSOCIATES II, L.P.
By Prospect Management Co. II, L.L.C.
Its General Partner
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By: |
/s/ Dave Markland, Attorney in Fact for |
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Name: |
Prospect Associates II, L.P.
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Managing Director |
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PROSPECT MANAGEMENT CO. II, L.L.C.
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By: |
/s/ Dave Markland, Attorney in Fact for |
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Name: |
Prospect Management Co. II, LLC
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Managing Director |
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/s/ Dave Markland, Attorney in Fact for |
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James B. Tananbaum, M.D.
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/s/ Dave Markland, Attorney in Fact for |
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Russell C. Hirsch, M.D., Ph.D.
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/s/ Dave Markland, Attorney in Fact for |
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David Schnell, M.D.
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