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) 03/25/2015 |
3. Issuer Name and Ticker or Trading Symbol
SolarEdge Technologies Inc [ SEDG ] |
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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 A Convertible Preferred Stock | (1) | (1) | Common Stock | 1,394,670 | (1) | I | By Pacven Walden Ventures VI, L.P.(2) |
Series A Convertible Preferred Stock | (1) | (1) | Common Stock | 108,598 | (1) | I | By Pacven Walden Ventures Parallel VI, L.P.(2) |
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 1,256,014 | (1) | I | By Pacven Walden Ventures VI, L.P.(2) |
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 97,801 | (1) | I | By Pacven Walden Ventures Parallel VI, L.P.(2) |
Series C Convertible Preferred Stock | (1) | (1) | Common Stock | 615,191 | (1) | I | By Pacven Walden Ventures VI, L.P.(2) |
Series C Convertible Preferred Stock | (1) | (1) | Common Stock | 47,903 | (1) | I | By Pacven Walden Ventures Parallel VI, L.P.(2) |
Series D Convertible Preferred Stock | (1) | (1) | Common Stock | 446,531 | (1) | I | By Pacven Walden Ventures VI, L.P.(2) |
Series D Convertible Preferred Stock | (1) | (1) | Common Stock | 34,769 | (1) | I | By Pacven Walden Ventures Parallel VI, L.P.(2) |
Series D-1 Convertible Preferred Stock | (1) | (1) | Common Stock | 120,845 | (1) | I | By Pacven Walden Ventures VI, L.P.(2) |
Series D-1 Convertible Preferred Stock | (1) | (1) | Common Stock | 9,409 | (1) | I | By Pacven Walden Ventures Parallel VI, L.P.(2) |
Series D-2 Convertible Preferred Stock | (1) | (1) | Common Stock | 145,014 | (1) | I | By Pacven Walden Ventures VI, L.P.(2) |
Series D-2 Convertible Preferred Stock | (1) | (1) | Common Stock | 11,291 | (1) | I | By Pacven Walden Ventures Parallel VI, L.P.(2) |
Series D-3 Convertible Preferred Stock | (1) | (1) | Common Stock | 242,353 | (1) | I | By Pacven Walden Ventures VI, L.P.(2) |
Series D-3 Convertible Preferred Stock | (1) | (1) | Common Stock | 18,871 | (1) | I | By Pacven Walden Ventures Parallel VI, L.P.(2) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. Each three (3) shares of the issuer's Series D-3, D-2, D-1, D, C, B, and A Convertible Preferred Stock will convert into one (1) share of the issuer's Common Stock immediately prior to the closing of an approved initial public offering meeting certain criteria ("IPO"). Such shares have no expiration date. |
2. Pacven Walden Management VI Co., Ltd. ("Pacven Mgmt VI"), the Designated Filer, is the general partner of Pacven Walden Ventures VI, L.P. ("Pacven VI") and Pacven Walden Ventures Parallel VI, L.P. ("Pacven Parallel VI") Pacven Mgmt VI is affiliated with Walden International, a venture capital firm. Mr. Lip-Bu Tan is the sole director and a member of the investment committee of Pacven Mgmt VI and shares voting and investment power with respect to the shares held by Pacven VI and Pacven Parallel VI with other members of the Investment Committee, i.e., Andrew Kau and Brian Chang. Each such person disclaims beneficial ownership of the shares in which he or she has no pecuniary interest. |
/s/ Lip-Bu Tan as director of Pacven Walden Management VI Co., Ltd., the General Partner of Pacven Walden Ventures VI, L.P. | 03/25/2015 | |
/s/ Lip-Bu Tan as director of Pacven Walden Management VI Co., Ltd., the General Partner of Pacven Walden Ventures Parallel VI, L.P. | 03/25/2015 | |
** 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. |