SEC FORM
4
SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
890 WINTER STREET |
SUITE 225 |
(Street)
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2. Issuer Name and Ticker or Trading Symbol
SYNCHRONOSS TECHNOLOGIES INC
[ SNCR ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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3. Date of Earliest Transaction
(Month/Day/Year) 06/20/2006
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4. 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 Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
06/20/2006 |
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C |
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3,751,830 |
A |
$0
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3,751,830 |
D
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Common Stock |
06/20/2006 |
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C |
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41,274 |
A |
$0
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41,274 |
I |
See Footnote
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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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 |
Series A Preferred Stock |
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06/20/2006 |
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C |
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3,751,830 |
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Common Stock |
3,751,830 |
$0
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0 |
D
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Series A Preferred Stock |
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06/20/2006 |
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C |
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41,274 |
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Common Stock |
41,274 |
$0
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0 |
I
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See Footnote
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Stock Option (Right to Buy) |
$8.98
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02/10/2016 |
Common Stock |
25,000 |
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25,000 |
I |
See Footnote
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1. Name and Address of Reporting Person*
890 WINTER STREET |
SUITE 225 |
(Street)
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1. Name and Address of Reporting Person*
890 WINTER STREET |
SUITE 225 |
(Street)
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1. Name and Address of Reporting Person*
ABS VENTURES |
1 SOUTH STREET |
(Street)
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1. Name and Address of Reporting Person*
890 WINTER STREET |
SUITE 225 |
(Street)
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Explanation of Responses: |
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/s/ Bruns H. Grayson |
06/22/2006 |
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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
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). |
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. |
STATEMENT APPOINTING DESIGNATED FILER AND AUTHORIZED SIGNATORIES
June 20, 2006
Each of the entities listed on SCHEDULE A attached hereto (each a
"Reporting Entity") and each party listed on SCHEDULE B attached hereto (each a
"Reporting Individual"; together with the Reporting Entities, the "Reporting
Persons") hereby authorizes and designates Bruns H. Grayson and R. William
Burgess Jr. (individually, each a "Designated Filer"), to prepare and file on
behalf of such Reporting Person individually, or jointly together with other
Reporting Persons, any and all reports, notices, communications and other
documents (including, but not limited to, reports on Schedule 13D, Schedule 13G,
Form 3, Form 4 and Form 5) that such Reporting Person may be required to file
with the United States Securities and Exchange Commission or with any regulatory
body, including United States federal, state and self-regulatory bodies, with
respect to the Reporting Person's ownership of, or transactions in, the
securities of any entity whose securities are beneficially owned (directly or
indirectly) by such Reporting Person (collectively, the "Companies").
Each Reporting Person hereby further authorizes and designates Bruns H.
Grayson and R. William Burgess Jr. ("Authorized Signatories") to execute and
file on behalf of such Reporting Person the Reports and to perform any and all
other acts, which in the opinion of a Designated Filer or an Authorized
Signatory may be necessary or incidental to the performance of the foregoing
powers herein granted.
The authority of the Designated Filer and each Authorized Signatory
under this Document with respect to each Reporting Person shall continue until
such Reporting Person is no longer required to file any Reports with respect to
the Reporting Person's ownership of, or transactions in, the securities of the
Companies, unless earlier revoked in writing. Each Reporting Person acknowledges
that the Designated Filer and the Authorized Signatory are not assuming any of
the Reporting Person's responsibilities to comply with any United States federal
or state law or with any regulations promulgated thereto.
In Witness Whereof, the undersigned has caused this Statement Appointing
Designated Filer and Authorized Signatory to be effective as of June 20, 2006.
Reporting Persons:
June 20, 2006 /s/ Bruns H. Grayson
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Bruns H. Grayson
June 20, 2006 /s/ R. William Burgess Jr.
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R. William Burgess Jr.
June 20, 2006 ABS Ventures VI L.P.
By: Calvert Capital IV L.L.C.
By: /s/ Bruns H. Grayson
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Bruns H. Grayson, Senior Manager
June 20, 2006 Calvert Capital IV L.L.C.
By: /s/ Bruns H. Grayson
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Bruns H. Grayson, Senior Manager
SCHEDULE A
ABS Ventures VI L.P.
Calvert Capital IV L.L.C.
SCHEDULE B
Bruns H. Grayson
R. William Burgess Jr.
JOINT FILER INFORMATION
Joint Filer Name: CALVERT CAPITAL IV L.L.C.
Relationship to Issuer: 10% Owner, as general partner of ABS Ventures VI L.P. (the
reporting person disclaims beneficial ownership of the
reported securities except to the extent of its pecuniary
interest therein)
Address: 890 Winter Street
Waltham, MA 02451
Designated Filer: ABS Ventures VI L.P.
Date of Event Requiring Statement: 6/20/06
Issuer Name and Ticker or Trading Symbol: SynchronOSS Technologies Inc. (SNCR)
Signature Calvert Capital IV L.L.C.
By: /s/ Bruns H. Grayson
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Senior Manager
Joint Filer Name: BRUNS H. GRAYSON
Relationship to Issuer: 10% Owner, as Senior Manager of Calvert Capital IV L.L.C.,
the general partner of ABS Ventures VI L.P., as Senior
Manager of ABS Investors L.L.C. and as an officer, director and
shareholder of Calvert Capital Management Company (the
reporting person disclaims beneficial ownership of the
reported securities except to the extent of his pecuniary
interest therein)
Address: 890 Winter Street
Waltham, MA 02451
Designated Filer: ABS Ventures VI L.P.
Date of Event Requiring Statement: 6/20/06
Issuer Name and Ticker or Trading Symbol: SynchronOSS Technologies Inc. (SNCR)
Signature /s/ Bruns H. Grayson
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Joint Filer Name: R. WILLIAM BURGESS JR.
Relationship to Issuer: 10% Owner, as Manager of Calvert Capital IV L.L.C., the
general partner of ABS Ventures VI L.P. and as an officer, director
and shareholder of Calvert Capital Management Company (the
reporting person disclaims beneficial ownership of the
reported securities except to the extent of his pecuniary
interest therein)
Address: 890 Winter Street
Waltham, MA 02451
Designated Filer: ABS Ventures VI L.P.
Date of Event Requiring Statement: 6/20/06
Issuer Name and Ticker or Trading Symbol: SynchronOSS Technologies Inc. (SNCR)
Signature /s/ R. William Burgess Jr.
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