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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/24/2011 |
3. Issuer Name and Ticker or Trading Symbol
ACTIVE NETWORK INC [ ACTV ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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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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Table I - Non-Derivative Securities Beneficially Owned | |||
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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) |
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) | 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) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series B-6 Preferred Stock | (1) | (1) | Common Stock | 1,428,810 | (1) | I | See footnotes(2)(3) |
Series C Preferred Stock | (1) | (1) | Common Stock | 1,895,519 | (1) | I | See footnotes(3)(4)(5) |
Series D Preferred Stock | (1) | (1) | Common Stock | 913,175 | (1) | I | See footnotes(3)(5)(6) |
Series E Preferred Stock | (1) | (1) | Common Stock | 1,875,705 | (1) | I | See footnotes(3)(5)(7)(8) |
Series F Preferred Stock | (1) | (1) | Common Stock | 820,163 | (1) | I | See footnotes(3)(5)(8)(9) |
Stock Option (Rignt to Buy) | 03/24/2011(10) | 03/24/2021 | Common Stock | 46,000 | $7.88 | D | |
Series E Preferred Stock | (1) | (1) | Common Stock | 12,112 | (1) | D | |
Series F Preferred Stock | (1) | (1) | Common Stock | 11,434 | (1) | D |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. Immediately prior to but contingent upon the closing of the initial public offering of the Issuer's Common Stock, all outstanding shares of Preferred Stock will be automatically converted, for no additional consideration, into shares of the Issuer's Common Stock. |
2. Consists of 74,298 shares held by Canaan Equity II Entrepreneurs LLC, 935,871 shares held by Canaan Equity II L.P. and 418,641 shares held by Canaan Equity II L.P. (QP). |
3. John V. Balen, Stephen L. Green, Deepak Karma, Gregory Kopchinsky, Guy M. Russo, Eric A. Young (the "Canaan II Individuals"), Charmers Landing LLC ("Charmers"), Stonehenge LLC ("Stonehenge") and Waubeeka LLC ("Waubeeka") are managers of Canaan Equity Partners II LLC which is (a) the sole Manager of Canaan Equity II Entrepreneurs LLC and (b) the sole General Partner of each of Canaan Equity II L.P and Canaan Equity II L.P. (QP). The sole managers of Charmers, Stonehenge and Waubeeka are Mr. Green, Mr. Kopchinsky and Mr. Russo, respectively. The Canaan II Individuals may be deemed to have shared voting, investment and dispositive power with respect to these shares, but disclaim beneficial ownership of all shares except to the extent of any pecuniary interest therein. |
4. Consists of 16,427 shares held by Canaan Equity II Entrepreneurs LLC, 206,927 shares held by Canaan Equity II L.P., 92,564 shares held by Canaan Equity II L.P. (QP), 56,865 shares held by Canaan Equity III Entrepreneurs LLC and 1,522,736 shares held by Canaan Equity III L.P. |
5. John V. Balen, Stephen L. Green, Deepak Karma, Gregory Kopchinsky, Seth A. Rudnick, Guy M. Russo, and Eric A. Young are Managers of Canaan Equity Partners III LLC which is (a) the sole Manager of Canaan Equity III Entrepreneurs LLC and (b) the sole General Partner of Canaan Equity III L.P. Such individuals may be deemed to have shared voting, investment and dispositive power with respect to these shares, but disclaim beneficial ownership of all shares except to the extent of any pecuniary interest therein. |
6. Consists of 24,921 shares held by Canaan Equity II Entrepreneurs LLC, 313,921 shares held by Canaan Equity II L.P., 140,425 shares held by Canaan Equity II L.P. (QP), 15,620 shares held by Canaan Equity III Entrepreneurs LLC and 418,288 shares held by Canaan Equity III L.P. |
7. Consists of 7,410 shares held by Canaan Equity II Entrepreneurs LLC, 93,334 shares held by Canaan Equity II L.P., 41,751 shares held by Canaan Equity II L.P. (QP), 5,130 shares held by Canaan Equity III Entrepreneurs LLC, 137,365 shares held by Canaan Equity III L.P. and 1,590,715 shares held by Canaan VII L.P. |
8. Brenton K. Ahrens, John V. Balen, Maha S. Ibrahim, Deepak Karma, Gregory Kopchinsky, Seth A. Rudnick, Guy M. Russo, Eric A. Young, Wende Hutton and Stephen Bloch are Managers of Canaan Partners VII LLC which is the sole General Partner of Canaan VII L.P. Such individuals may be deemed to have shared voting, investment and dispositive power with respect to these shares, but disclaim beneficial ownership of all shares except to the extent of any pecuniary interest therein. Mr. Green is a member of Canaan Partners VII LLC, does not have voting or dispositive power over the shares held by Canaan VII L.P., and disclaims beneficial ownership of the shares held by Canaan VII L.P. except to the extent of his pecuniary interest therein. |
9. Consists of 1,801 shares held by Canaan Equity II Entrepreneurs LLC, 22,695 shares held by Canaan Equity II L.P., 10,152 shares held by Canaan Equity II L.P. (QP), 1,247 shares held by Canaan Equity III Entrepreneurs LLC, 33,402 shares held by Canaan Equity III L.P. and 750,866 shares held by Canaan VII L.P. |
10. The options are immediately exercisable, but shares purchased under such option are subject to repurchase by the Issuer at the option exercise price upon Mr. Green's termination of service to the Issuer prior to vesting of these shares. 33% of the option shares vest on the first annual anniversary of such date with the remaining option shares vesting in 24 equal monthly installments thereafter. |
Remarks: |
This filing is the second of three Form 3s filed by the joint filers. Multiple forms are required because there are more than ten joint filers. Exhibit List: Exhibit 24 - Powers of Attorney Exhibit 99.1 - Signatures of joint filers |
See Signatures on Exhibit | 05/24/2011 | |
** 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. |