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 of Derivative Security: 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 Preferred Stock
(1)
|
Â
(2)
|
Â
(3)
|
Common Stock
|
69,361
|
$
(1)
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(4)
|
01/26/2016 |
Common Stock
|
10,078
(5)
|
$
0.49
(5)
|
D
|
Â
|
Stock Option (Right to Buy)
|
Â
(4)
|
01/26/2016 |
Common Stock
|
45,903
(6)
|
$
0.6
(6)
|
D
|
Â
|
* |
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). |
(1) |
These securities will be exchanged for common stock of the Issuer on the effective date of the Issuer's initial public offering in a corporate reorganization. |
(2) |
Immediately exercisable. |
(3) |
No expiration date. |
(4) |
These options are 25% vested as of the date hereof and will vest 25% per year on each of January 27, 2008, January 27, 2009 and January 27, 2010. |
(5) |
Ms. Pitcher has an option to purchase 23,500 shares of common stock of the Issuer's subsidiary, Lululemon Athletica USA Inc., at an exercise price of $0.21 per share. The option will be exchanged in the Issuer's corporate reorganization for an option to purchase the number of shares of the Issuer's common stock shown in the table, at the exercise price shown in the table. |
(6) |
Ms. Pitcher has an option to purchase 23,500 shares of common stock of the Issuer's subsidiary, Lululemon Athletica, Inc., at an exercise price of $1.18 per share. The option will be exchanged in the Issuer's corporate reorganization for an option to purchase the number of shares of the Issuer's common stock shown in the table, at the exercise price shown in the table. |