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*
ONE EMBARCADERO CENTER |
SUITE 4050 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/31/2004
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3. Issuer Name and Ticker or Trading Symbol
CUTERA INC
[ CUTR ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
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 Preferred Stock |
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Common Stock |
1,375,000 |
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I |
See Footnote #1
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1. Name and Address of Reporting Person*
ONE EMBARCADERO CENTER |
SUITE 4050 |
(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADERO CENTER |
SUITE 4050 |
(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADERO CENTER |
SUITE 4050 |
(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADEOR CENTER |
SUITE 4050 |
(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADEOR CENTER |
SUITE 4050 |
(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADEOR CENTER |
SUITE 4050 |
(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADEOR CENTER |
SUITE 4050 |
(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADEOR CENTER |
SUITE 4050 |
(Street)
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1. Name and Address of Reporting Person*
ONE EMBARCADEOR CENTER |
SUITE 4050 |
(Street)
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Explanation of Responses: |
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/s/ Guy Nohra, Vice President, Alta Partners |
03/30/2004 |
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/s/ Guy Nohra, Member, Alta California Managament II, LLC |
03/30/2004 |
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/s/ Garrett Gruener, Member, Alta Embarcadero Partners II, LLC |
03/30/2004 |
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/s/ Jean Delenge |
03/30/2004 |
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/s/ Garrett Gruener |
03/30/2004 |
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/s/ Alix Marduel |
03/30/2004 |
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/s/ Guy Nohra |
03/30/2004 |
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/s/ Daniel Janney |
03/30/2004 |
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/s/ Guy Nohra, Member, Alta California Management II, LLC, its General Partner |
03/30/2004 |
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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. |
rrd29567_33573.html
Footnote # 1
Guy Nohra, Director, is a member of Alta California Management Partners II, LLC ("ACMPII")
(which is the general partner ("gp") of Alta California Partners II, L.P. ("ACPII")) and a member of
Alta Embarcadero Partners II, LLC ("AEPII"). He disclaims beneficial ownership of all such shares
held by all of the foregoing funds except to the extent of his proportionate pecuniary interests
therein. Alta Partners ("AP") provides investment advisory services to several venture capital
funds including ACPII & AEPII. ACPII beneficially owns 1,357,846 shares of Series B Preferred
Stock ("Ser B'). AEPII beneficially owns 17,154 shares of Ser B. The respective gp of ACPII &
members of AEPII exercise sole voting and investment power with respect to the shares
owned by such funds. Jean Deleage, Garrett Gruener, Guy Nohra, Daniel Janney and Alix
Marduel are members of ACMPII (which is the gp of ACPII), and Jean Deleage, Garrett Gruener
and Guy Nohra are members of AEPII (collectively known as the "principals'). As members of
such funds, they may be deemed to share voting and investment powers for the shares held by
the funds. The principals disclaim beneficial ownership of all such shares held by the foregoing
funds, except to the extent of their proportionate pecuniary interests therein.