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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 | ||||||||
Warrant (right to buy) | $ 5 | 07/12/2005 | A | 173,081 | (3) | 07/12/2010 | Common Stock | 173,081 | $ 5 | 173,081 | I | By Amadeus II A LP | |||
Warrant (right to buy) | $ 5 | 07/12/2005 | A | 115,387 | (3) | 07/12/2010 | Common Stock | 115,387 | $ 5 | 115,387 | I | By Amadeus II B LP | |||
Warrant (right to buy) | $ 5 | 07/12/2005 | A | 80,772 | (3) | 07/12/2010 | Common Stock | 80,772 | $ 5 | 80,772 | I | By Amadeus II C LP | |||
Warrant (right to buy) | $ 5 | 07/12/2005 | A | 3,847 | (3) | 07/12/2010 | Common Stock | 3,847 | $ 5 | 3,847 | I | By Amadeus II D GmbH & Co KG | |||
Warrant (right to buy) | $ 5 | 07/12/2005 | A | 11,539 | (3) | 07/12/2010 | Common Stock | 11,539 | $ 5 | 11,539 | I | By Amadeus II Affiliates LP |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HAUSER HERMANN C/O AMADEUS CAPITAL PARTNERS LIMITED MOUNT PLEASANT HOUSE, 2 MOUNT PLEASANT HUNTINGDON ROAD, CAMBRIDGE, X0 CB3 ORN |
X |
Hermann Hauser, Director Amadeus Capital Partners Ltd. | 07/11/2005 | |
**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) | The Reporting Person shares the power to vote and control the disposition of shares held by Amadeus II A LP, Amadeus II B LP, Amadeus II C LP, Amadeus II D GmbH & Co KG and Amadeus II Affiliates LP. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pro-rata interest herein. |
(2) | The shares were issued in connection with the reallocation of an aggregate of 7,198 shares of common stock of Solexa, Inc. (the "Company") to the former shareholders of Solexa Limited in connection with the business combination between the Company and Solexa Limited completed on March 4, 2005. |
(3) | Warrants are exercisable 180 days from the transaction close date of July 12, 2005. |