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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 | ||||||||
Stock Option (right to buy) | $ 2.2 | 04/26/2016 | X | 5,000 | (5) | 05/13/2016 | Common Stock | 5,000 | $ 0 | 0 | I (2) (3) | See Footnotes (2) (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Capital Z Partners III GP, Ltd. 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | |||
Capital Z Partners Management, LLC 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | |||
Capital Z Partners III, L.P. 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | |||
Capital Z Partners III GP, L.P. 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | |||
CAPITAL Z FINANCIAL SERVICES PRIVATE FUND II, L.P. 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | |||
CAPITAL Z FINANCIAL SERVICES FUND II LP 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | |||
CAPITAL Z PARTNERS LP 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | |||
CAPITAL Z PARTNERS LTD 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | |||
COOPER BRADLEY E 142 WEST 57TH STREET NEW YORK, NY 10019 |
X | X |
/s/ Craig Fisher, Authorized Signatory for Capital Z Partners III GP, Ltd. | 04/28/2016 | |
**Signature of Reporting Person | Date | |
/s/ Craig Fisher, Authorized Signatory for Capital Z Partners Management, LLC | 04/28/2016 | |
**Signature of Reporting Person | Date | |
/s/ Craig Fisher, Authorized Signatory for Capital Z Partners III, L.P. | 04/28/2016 | |
**Signature of Reporting Person | Date | |
/s Craig Fisher, Authorized Signatory for Capital Z Partners III GP, L.P. | 04/28/2016 | |
**Signature of Reporting Person | Date | |
/s/ Craig Fisher, Authorized Signatory for Capital Z Financial Services Private Fund II, L.P. | 04/28/2016 | |
**Signature of Reporting Person | Date | |
/s/ Craig Fisher, Authorized Signatory for Capital Z Financial Services Fund II, L.P. | 04/28/2016 | |
**Signature of Reporting Person | Date | |
/s/ Craig Fisher, Authorized Signatory for Capital Z Partners, L.P. | 04/28/2016 | |
**Signature of Reporting Person | Date | |
/s/ Craig Fisher, Authorized Signatory for Capital Z Partners, Ltd. | 04/28/2016 | |
**Signature of Reporting Person | Date | |
/s/ Bradley E. Cooper | 04/28/2016 | |
**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) | See Footnote 1 in Exhibit 99.1. |
(2) | See Footnote 2 in Exhibit 99.1. |
(3) | See Footnote 3 in Exhibit 99.1. |
(4) | See Footnote 4 in Exhibit 99.1. |
(5) | The options became fully vested and exercisable as of May 13, 2012. |
Remarks: See Exhibit 99.1 - Footnotes incorporated herein by reference. Capital Z Partners III GP, Ltd. is the designated filer for all the reporting persons on this Form 4. |