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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1. Name and Address of Reporting Person*
Montreux Equity Management IV, LLC

(Last) (First) (Middle)
C/O MONTREUX
ONE FERRY BUILDING, SUITE 255

(Street)
SAN FRANCISCO CA 94111

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/24/2015
3. Issuer Name and Ticker or Trading Symbol
GLAUKOS Corp [ GKOS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
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)
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 Convertible Preferred Stock (1) (1) Common Stock 1,415,449 (1) I Through Montreux Equity Partners IV, L.P.(2)
Series C Convertible Preferred Stock (1) (1) Common Stock 108,360 (1) I Through Montreux IV Associates, LLC(2)
Series D Convertible Preferred Stock (1) (1) Common Stock 630,788 (1) I Through Montreux Equity Partners IV, L.P.(2)
Series D Convertible Preferred Stock (1) (1) Common Stock 37,186 (1) I Through Montreux IV Associates, LLC(2)
Series E Convertible Preferred Stock (1) (1) Common Stock 288,429 (1) I Through Montreux Equity Partners IV, L.P.(2)
Series F Convertible Preferred Stock (1) (1) Common Stock 783,740 (1) I Through Montreux Equity Partners IV, L.P.(2)
Series F Convertible Preferred Stock (1) (1) Common Stock 15,860 (1) I Through Montreux IV Associates, LLC(2)
1. Name and Address of Reporting Person*
Montreux Equity Management IV, LLC

(Last) (First) (Middle)
C/O MONTREUX
ONE FERRY BUILDING, SUITE 255

(Street)
SAN FRANCISCO CA 94111

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
MONTREUX EQUITY PARTNERS IV LP

(Last) (First) (Middle)
C/O MONTREUX
ONE FERRY BUILDING, SUITE 255

(Street)
SAN FRANCISCO CA 94111

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Montreux IV Associates, LLC

(Last) (First) (Middle)
C/O MONTREUX
ONE FERRY BUILDING, SUITE 255

(Street)
SAN FRANCISCO CA 94111

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The shares of Series C Convertible Preferred Stock, Series D Convertible Preferred Stock, Series E Convertible Preferred Stock and Series F Convertible Preferred Stock shall automatically convert into shares of common stock on a 1:1 basis immediately prior to the consummation of the Issuer's initial public offering ("IPO") and have no expiration date.
2. Montreux Equity Management IV, LLC, a California limited liability company (''MEM IV'') serves as the sole general partner of Montreux Equity Partners IV, L.P., a California limited partnership (''MEP IV'') and as manager of Montreux IV Associates, LLC, a California limited liability company (''MA IV''). John Savarese, M.D., Howard D. Palefsky and Daniel K. Turner III are directors and/or members of MEM IV and share voting and dispositive power over the shares held by MEP IV, MA IV and MEM IV; however, they disclaim beneficial ownership of the shares held by such entities except to the extent of their pecuniary interests therein.
/s/ Daniel K. Turner III, Managing Director 06/24/2015
** 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).
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