SEC Filing | Cutera Inc.

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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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1. Name and Address of Reporting Person^*

CAMPBELL WHITE ANNETTE

(Last)

(First)

(Middle)

C/O MEDVENTURE ASSOCIATES

5980 HORTON STREET, SUITE 390

(Street)

EMERYVILLE

94608

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
03/31/2004

3. Issuer Name and Ticker or Trading Symbol
CUTERA INC [ CUTR ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
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)
Common Stock	152,964	I	MedVenture Associates III, L.P.⁽¹⁾
Common Stock	6,507	I	MedVen Affiliates III, L.P.⁽¹⁾

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Series A Convertible Preferred Stock	⁽²⁾	⁽⁴⁾	Common Stock	1,439,759	⁽³⁾	I	MedVenture Associates III, L.P.⁽¹⁾
Series A Convertible Preferred Stock	⁽²⁾	⁽⁴⁾	Common Stock	61,241	⁽³⁾	I	MedVen Affiliates III, L.P.⁽¹⁾
Series B Convertible Preferred Stock	⁽²⁾	⁽⁴⁾	Common Stock	1,246,960	⁽³⁾	I	MedVenture Associates III, L.P.⁽¹⁾
Series B Convertible Preferred Stock	⁽²⁾	⁽⁴⁾	Common Stock	53,040	⁽³⁾	I	MedVen Affiliates III, L.P.⁽¹⁾

Explanation of Responses:

1. The reporting person is a member of MedVentures Associates Management III Co., LLC, which is the general partner of MedVenture Associates III, L.P. and MedVen Affiliates III, L.P. The reporting person disclaims beneficial ownership of the securities except to the extent of her pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose.

2. Immed.

3. 1-for-1

4. N/A

	/s/ Annette J. Campbell-White	03/30/2004
	** 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.