UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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 control number. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
PUTNAM JUSTYN RENDAL 200 N. HAMILTON STREET, NO. 200 HIGH POINT, NC 27260 |
 X |  |  |  |
/s/Anita W. Wimmer as Power of Attorney | 01/20/2016 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Does not include 693,146 shares held by Talanta Fund, L.P. (the "Fund") over which the Reporting Person shares voting and dispositive power as a result of his service as managing member of the Fund's general partner. Also does not include an aggregate of 642,798 shares held by Hale Partnership Fund, L.P. and MGEN II - Hale Fund, L.P. which, together with certain affiliates, filed a schedule 13D with the Fund, the Fund's general partner and the Reporting Person that was most recently amended on January 13, 2016. |