| 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) 03/21/2013 |
3. Issuer Name and Ticker or Trading Symbol
MARIN SOFTWARE INC [ MRIN ] |
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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) |
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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) | 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 C Preferred Stock | (1) | (1) | Common Stock | 206,164 | (1) | I | Held by DAG Ventures IV, L.P.(2) |
| Series D Preferred Stock | (1) | (1) | Common Stock | 69,072 | (1) | I | Held by DAG Ventures IV, L.P.(2) |
| Series E Preferred Stock | (1) | (1) | Common Stock | 16,918 | (1) | I | Held by DAG Ventures IV, L.P.(2) |
| Series F Preferred Stock | (1) | (1) | Common Stock | 19,433 | (1) | I | Held by DAG Ventures IV, L.P.(2) |
| Series F-1 Preferred Stock | (1) | (1) | Common Stock | 17,371 | (1) | I | Held by DAG Ventures IV, L.P.(2) |
| Series C Preferred Stock | (1) | (1) | Common Stock | 359,492 | (1) | I | Held by DAG Ventures IV-A, LLC(2) |
| Series C Preferred Stock | (1) | (1) | Common Stock | 1,950,791 | (1) | I | Held by DAG Ventures IV-QP, L.P.(2) |
| Series D Preferred Stock | (1) | (1) | Common Stock | 653,588 | (1) | I | Held by DAG Ventures IV-QP, L.P.(2) |
| Series E Preferred Stock | (1) | (1) | Common Stock | 160,086 | (1) | I | Held by DAG Ventures IV-QP, L.P.(2) |
| Series F Preferred Stock | (1) | (1) | Common Stock | 183,882 | (1) | I | Held by DAG Ventures IV-QP, L.P.(2) |
| Series F-1 Preferred Stock | (1) | (1) | Common Stock | 164,372 | (1) | I | Held by DAG Ventures IV-QP, L.P.(2) |
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. Each share of Preferred Stock will automatically convert into one (1) share of the Issuer's Common Stock upon the closing of the Issuer's initial public offering of Common Stock for no additional consideration, and has no expiration date. |
| 2. DAG Ventures Management IV, LLC ("DAG IV LLC") serves as the General Partner of DAG Ventures IV, L.P. ("DAG IV") and DAG Ventures IV-QP, L.P. ("DAG IV-QP"), and serves as the Manager of DAG Ventures IV-A, LLC ("DAG IV-A"), and possesses power to direct the voting and disposition of the securities held by such entities. DAG IV LLC disclaims beneficial ownership over such securities except to the extent of its pecuniary interest therein. Messrs. John J. Cadeddu, R. Thomas Goodrich, Young J. Chung, Nicholas K. Pianim and Greg Williams are Managing Directors of DAG IV LLC. As such, each of such individuals possesses power to direct the voting and disposition of the shares held of record by DAG IV, DAG IV-A and DAG IV-QP. Each of such individuals disclaims beneficial ownership of such securities except to the extent of his or her pecuniary interest therein. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securiti |
| Remarks: |
| /s/ R. Thomas Goodrich as Managing Director of DAG Ventures Management IV, LLC, the General Partner of DAG Ventures IV, L.P. | 03/21/2013 | |
| /s/ R. Thomas Goodrich as Managing Director of DAG Ventures Management IV, LLC, the General Partner of DAG Ventures IV-QP, L.P. | 03/21/2013 | |
| /s/ R. Thomas Goodrich as Managing Director of DAG Ventures Management IV, LLC, the Manager of DAG Ventures IV-A, LLC | 03/21/2013 | |
| /s/ R. Thomas Goodrich, by power of attorney for John J. Cadeddu | 03/21/2013 | |
| /s/ R. Thomas Goodrich, by power of attorney for Young J. Chung | 03/21/2013 | |
| /s/ R. Thomas Goodrich, by power of attorney for Nicholas K. Pianim | 03/21/2013 | |
| /s/ R. Thomas Goodrich, by power of attorney for Greg Williams | 03/21/2013 | |
| /s/ R. Thomas Goodrich as Managing Director of DAG Ventures Management IV, LLC | 03/21/2013 | |
| /s/ R. Thomas Goodrich | 03/21/2013 | |
| ** 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. | ||