SEC FORM
3
SEC Form 3
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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
525 UNIVERSITY AVENUE |
SUITE 800 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/25/2015
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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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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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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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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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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)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series D Convertible Preferred Stock |
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Common Stock |
2,887,252 |
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I |
See Footnote
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Series D-1 Convertible Preferred Stock |
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Common Stock |
93,985 |
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I |
See Footnote
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Series D-2 Convertible Preferred Stock |
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Common Stock |
112,782 |
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I |
See Footnote
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Series D-3 Convertible Preferred Stock |
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Common Stock |
188,486 |
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I |
See Footnote
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1. Name and Address of Reporting Person*
525 UNIVERSITY AVENUE |
SUITE 800 |
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
525 UNIVERSITY AVENUE |
SUITE 800 |
(Street)
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1. Name and Address of Reporting Person*
525 UNIVERSITY AVENUE |
SUITE 800 |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Kurt Betcher, Chief Financial Officer |
03/25/2015 |
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** 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. |
Exhibit 99.1
FORM 3
JOINT FILER INFORMATION
Name of "Reporting Persons": Norwest Venture Partners XI, LP
Jeffrey Crowe
Promod Haque
Matthew D. Howard
Address: 525 University Avenue, Suite 800
Palo Alto, CA 94301
Designated Filer: Norwest Venture Partners XI, LP
Issuer and Ticker Symbol: SolarEdge Technologies Inc. (SEDG)
Date of Earliest Transaction: March 25, 2015
Jeffrey Crowe, Promod Haque and Matthew D. Howard are Joint Filers with Norwest
Venture Partners XI, LP ("NVP XI") and may be deemed to share indirect
beneficial ownership in the securities set forth on the attached Form 3.
Mssrs. Crowe, Haque and Howard are Co-Chief Executive Officers of NVP
Associates, LLC ("NVP Associates"), the managing member of the general partner
of NVP XI. By virtue of such position, Mssrs. Crowe, Haque and Howard may be
deemed to beneficially own the shares held of record by NVP XI.
All Reporting Persons disclaim beneficial ownership of shares of SolarEdge
Technogies Inc. stock held by each other Reporting Person, except to the extent
of their respective pecuniary interest therein. The filing of this statement
shall not be deemed an admission that, for purposes of Section 16 of the
Securities Exchange Act of 1934, or otherwise, any of the Reporting Persons are
the beneficial owners of all of the equity securities covered by this statement.
Each of the Reporting Persons listed above hereby designates NVP XI as its
designated filer of Forms 3, 4 and 5 in accordance with Section 16(a) of the
Securities Exchange Act of 1934 and the rules thereunder.
NORWEST VENTURE PARTNERS XI, LP
By: Genesis VC Partners XI, LLC
Its General Partner
By: NVP Associates, LLC
Its Managing Member
By: /s/ Kurt Betcher
Its Chief Financial Officer
By: /s/ Kurt Betcher
JEFFREY CROWE
By: Kurt L. Betcher, as Attorney-in-Fact
By: /s/ Kurt Betcher
PROMOD HAQUE
By: Kurt L. Betcher, as Attorney-in-Fact
By: /s/ Kurt Betcher
MATTHEW D. HOWARD
By: Kurt L. Betcher, as Attorney-in-Fact