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) 04/28/2004 |
3. Issuer Name and Ticker or Trading Symbol
CYTOKINETICS INC [ CYTK ] |
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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 A Preferred Stock | (1) | (1) | Common Stock | 1,122,000 | 0 | I | See Footnote(2) |
Series B Preferred Stock | (1) | (1) | Common Stock | 515,688 | 0 | I | See Footnote(3) |
Series C Preferred Stock | (1) | (1) | Common Stock | 105,263 | 0 | I | See Footnote(4) |
Explanation of Responses: |
1. Each share of Series A Preferred Stock, Series B Preferred Stock, and Series C Preferred Stock may be converted at any time into common stock on a 1-for-2 basis; automatically converts at the closing of an initial public offering. |
2. Total common shares of 1,122,000 represents 1,040,094 of such common shares held by Sevin Rosen Fund VI L.P. (SRFVI), 81,906 of such common shares held by Sevin Rosen VI Affiliates Fund L.P. (SRFVI AFF). SRB Associates VI L.P. (SRB) is the general partner of SRFVI and SRFVI AFF, and in that capacity, has shared voting and dispositive power over such shares. SRB disclaims beneficial ownership of such shares except to the extent of its pecuniary interest. |
3. Total common shares of 515,688, represents 478,043 of such common shares held by SRFVI and 37,645 of such common shares held by SRFVI AFF. SRB is the general partner of SRFVI and SRFVI AFF, and in that capacity, has shared voting and dispositive power over such shares. SRB disclaims beneficial ownership of such shares except to the extent of its pecuniary interest. |
4. Total common shares of 105,263 represents 97,579 of such common shares held by SRFVI and 7,684 of such common shares held by SRFVI AFF. SRB is the general partner of SRFVI and SRFVI AFF, and in that capacity, has shared voting and dispositive power over such shares. SRB disclaims beneficial ownership of such shares except to the extent of its pecuniary interest. |
John V. Jaggers, General Partner, By Power Of Attorney | 04/28/2004 | |
** 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. |