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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
|
|||||||||||||||
|
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*
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
IPASS INC [ IPAS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
||||||||||||||||||||||||
3. Date of Earliest Transaction
(Month/Day/Year)
07/29/2003 |
||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 07/29/2003 ( 1 ) | C | 2,729,445 | A | $0 | 2,729,445 | I | These shares are held directly by Accel V L.P. ( 2 ) ( 3 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 1,313,427 | A | $0 | 1,313,427 | I | These shares are held directly by Accel V L.P. ( 2 ) ( 3 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 1,220,736 | A | $0 | 1,220,736 | I | These shares are held directly by Accel V. L.P. ( 2 ) ( 3 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 614,245 | A | $0 | 614,245 | I | These shares are held directly by Accel V. L.P. ( 2 ) ( 3 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 813,357 | A | $0 | 813,357 | I | These shares are held directly by Accel V L.P. ( 2 ) ( 3 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 162,546 | A | $0 | 162,546 | I | These shares are held directly by Accel Investors '96 LP ( 2 ) ( 4 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 78,219 | A | $0 | 78,219 | I | These shares are held directly by Accel Investors '96 LP ( 2 ) ( 4 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 72,699 | A | $0 | 72,699 | I | These shares are held directly by Accel Investors '96 LP ( 2 ) ( 4 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 36,580 | A | $0 | 36,580 | I | These shares are held directly by Accel Investors '96 LP ( 2 ) ( 4 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 365,733 | A | $0 | 365,733 | I | These shares are held directly by Accel Internet/Strategic Technology Fund L.P. ( 2 ) ( 5 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 175,992 | A | $0 | 175,992 | I | These shares are held directly by Accel Internet/Strategic Technology Fund L.P. ( 2 ) ( 5 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 163,572 | A | $0 | 163,572 | I | These shares are held directly by Accel Internet/Strategic Technology Fund L.P. ( 2 ) ( 5 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 82,306 | A | $0 | 82,306 | I | These shares are held directly by Accel Internet/Strategic Technology Fund L.P. ( 2 ) ( 5 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 54,183 | A | $0 | 54,183 | I | These shares are held directly by Accel Keiretsu V. L.P. ( 2 ) ( 6 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 26,073 | A | $0 | 26,073 | I | These shares are held directly by Accel Keiretsu V. L.P. ( 2 ) ( 6 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 24,234 | A | $0 | 24,234 | I | These shares are held directly by Accel Keiretsu V. L.P. ( 2 ) ( 6 ) | ||
Common Stock | 07/29/2003 ( 1 ) | C | 12,193 | A | $0 | 12,193 | I | These shares are held directly by Accel Keiretsu V. L.P. ( 2 ) ( 6 ) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities) |
|||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series B Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 2,729,445 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 2,729,445 | $0 | 0 | I | These shares are held directly by Accel V L.P. ( 2 ) ( 3 ) | |||
Series C Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 1,313,427 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 1,313,427 | $0 | 0 | I | These shares are held directly by Accel V L.P. ( 2 ) ( 3 ) | |||
Series D Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 1,220,736 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 1,220,736 | $0 | 0 | I | These shares are held directly by Accel V L.P. ( 2 ) ( 3 ) | |||
Series E Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 614,245 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 614,245 | $0 | 0 | I | These shares are held directly by Accel V L.P. ( 2 ) ( 3 ) | |||
Series F Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 813,357 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 813,357 | $0 | 0 | I | These shares are held directly by Accel V L.P. ( 2 ) ( 3 ) | |||
Series B Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 162,546 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 162,546 | $0 | 0 | I | These shares are held directly by Accel Investors '96 LP ( 2 ) ( 4 ) | |||
Series C Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 78,219 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 78,219 | $0 | 0 | I | These shares are held directly by Accel Investors '96 LP ( 2 ) ( 4 ) | |||
Series D Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 72,699 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 72,699 | $0 | 0 | I | These shares are held directly by Accel Investors '96 LP ( 2 ) ( 4 ) | |||
Series E Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 36,580 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 36,580 | $0 | 0 | I | These shares are held directly by Accel Investors '96 LP ( 2 ) ( 4 ) | |||
Series B Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 365,733 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 365,733 | $0 | 0 | I | These shares are held directly by Accel Internet/Strategic Technology Fund L.P. ( 2 ) ( 5 ) | |||
Series C Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 175,992 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 175,992 | $0 | 0 | I | These shares are held directly by Accel Internet/Strategic Technology Fund L.P. ( 2 ) ( 5 ) | |||
Series D Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 163,572 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 163,572 | $0 | 0 | I | These shares are held directly by Accel Internet/Strategic Technology Fund L.P. ( 2 ) ( 5 ) | |||
Series E Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 82,306 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 82,306 | $0 | 0 | I | These shares are held directly by Accel Internet/Strategic Technology Fund L.P. ( 2 ) ( 5 ) | |||
Series B Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 54,183 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 54,183 | $0 | 0 | I | These shares are held directly by Accel Keiretsu V L.P. ( 2 ) ( 6 ) | |||
Series C Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 26,073 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 26,073 | $0 | 0 | I | These shares are held directly by Accel Keiretsu V L.P. ( 2 ) ( 6 ) | |||
Series D Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 24,234 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 24,234 | $0 | 0 | I | These shares are held directly by Accel Keiretsu V L.P. ( 2 ) ( 6 ) | |||
Series E Preferred Stock | $0 | 07/29/2003 ( 1 ) | C | 12,193 | 07/29/2003 ( 1 ) | 07/29/2003 ( 1 ) | Common Stock | 12,193 | $0 | 0 | I | These shares are held directly by Accel Keiretsu V L.P. ( 2 ) ( 6 ) |
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
Explanation of Responses: |
1. Mandatory conversion into Common Stock on a 1-for-1 basis upon the closing of the Issuer's initial public offering and has no expiration date. |
2. Reporting person disclaims beneficial ownership of the shares, for the purposes of Section 16 or for any other purpose, owned by the referenced entities except to the extent of his pecuniary interest therein. |
3. Shares are owned directly by Accel V L.P. ("A5"). The general partner of A5 is Accel V Associates L.L.C., the Managing Members of which are Arthur C. Patterson, Arthur C. Patterson Family Partnership L.P., of which Arthur C. Patterson is the general partner, James R. Swartz, James W. Breyer, Eugene D. Hill, Homestake Partners L.P., of which James R. Swartz is the general partner, Luke B. Evnin and J. Peter Wagner. |
4. Shares are owned directly by Accel Investors '96 L.P. ("AI96"), which is a member of a group with the other joint filers for purposes of Section 13(d) of the Exchange Act. The general partners of AI96 are Arthur C. Patterson, James R. Swartz, James W. Breyer, Luke B. Evnin, Eugene D. Hill and J. Peter Wagner. |
5. Shares are owned directly by Accel Internet/Strategic Technology Fund L.P.. ("AISTF"), which is a member of a group with the other joint filers for purposes of Section 13(d) of the Exchange Act. The general partner of AISTF is Accel Internet/Strategic Technology Fund Associates L.L.C., the Managing Members of which are Arthur C. Patterson, Arthur C. Patterson Family Partnership L.P., of which Arthur C. Patterson is the general partner, James R. Swartz, James W. Breyer, Eugene D. Hill, Luke B. Evnin, J. Peter Wagner and Homestake Partners L.P., of which James R. Swartz is the general partner. |
6. Shares are owned directly by Accel Keiretsu V L.P. ("AK5"), which is a member of a group with the other joint filers for purposes of Section 13(d) of the Exchange Act. The general partner of AK5 is Accel Keiretsu V Associates L.L.C. ("AK5A"), the Managing Members of which are Arthur C. Patterson, James R. Swartz, James W. Breyer, Eugene D. Hill, Luke B. Evnin and J. Peter Wagner. |
Remarks: |
Tracy L. Sedlock as Attorney in Fact for James R. Swartz | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for Accel V L. P. | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for Accel V Associates L.L.C. | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for Accel Internet/Strategic Technology Fund L.P. | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for Accel Internet/Strategic Technology Fund Associates L.L.C. | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for Accel Keiretsu V L.P. | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for Accel Keiretsu V Associates L.L.C. | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for Accel Investors '96 L.L.C. | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for ACP Family Partnership L.P. | 07/23/2003 | |
Tracy L. Sedlock as Attorney in Fact for Homestake Partners L.P. | 07/23/2003 | |
** 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. |