SEC FORM
3/A
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) 03/22/2004
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3. Issuer Name and Ticker or Trading Symbol
XCYTE THERAPIES INC
[ XCYT ]
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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) 03/10/2004
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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 |
Director Stock option |
03/19/2004 |
11/15/2006 |
Common Stock |
30,000 |
0.055 |
D
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Series A Convertible Preferred Stock |
03/19/2004 |
03/19/2004 |
Common Stock |
1,894,737 |
5.225 |
I |
See Footnote
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Series B Convertible Preferred Stock |
03/19/2004 |
03/19/2004 |
Common Stock |
805,281 |
6.05 |
I |
See Footnote
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Series C Convertible Preferred Stock |
03/19/2004 |
03/19/2004 |
Common Stock |
971,331 |
9.185 |
I |
See Footnote
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Series D Convertible Preferred Stock |
03/19/2004 |
03/19/2004 |
Common Stock |
584,547 |
15.29 |
I |
See Footnote
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Series E Convertible Preferred Stock |
03/19/2004 |
03/19/2004 |
Common Stock |
359,712 |
15.29 |
I |
See Footnote
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Common Stock Warrants (right to buy) |
03/19/2004 |
08/07/2005 |
Common Stock |
65,468 |
0.055 |
I |
See Footnote
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Common Stock Warrants (right to buy) |
03/19/2004 |
11/13/2006 |
Common Stock |
195,844 |
0.055 |
I |
See Footnote
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6% Convertible Promissory Note |
03/19/2004 |
03/19/2004 |
Common Stock |
$1,250,000
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9.625 |
I |
See Footnote
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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 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 EMBARCADERO CENTER |
SUITE 4050 |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Jean Deleage |
03/22/2004 |
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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. |
rrd28862_32751.html
Holder Type of Security Shares of Stock Held by the Holder
Alta California Partners, L.P. Common Stock 130,207
Alta California Partners, L.P. Series A 1,840,086
Alta California Partners, L.P. Series B 787,294
Alta California Part
ners, L.P. Series C 949,635
Alta California Partners, L.P. Series D 571,491
Alta California Partners, L.P. Series E 351,677
Alta California Partners, L.P. Warrants for Common Stock * 255,475
Alta Embarcadero Partners, LLC &n
bsp; Common Stock 2,974
Alta Embarcadero Partners, LLC Series A 54,651
Alta Embarcadero Partners, LLC Series B 17,987
Alta Embarcadero Partners, LLC Series C 21,696
Alta Embarcadero Partners, LLC Series D
13,056
Alta Embarcadero Partners, LLC Series E 8,035
Alta Embarcadero Partners, LLC Warrants for Common Stock * 5,837
*Warrants for Common Stock will be net exercised for Common Stock at the Issuer's initial public offering. The number of shares received will depend on the initial public offering price of the Common Stock