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) 02/08/2007 |
3. Issuer Name and Ticker or Trading Symbol
ACCURAY INC [ ARAY ] |
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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) 02/07/2007 |
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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) |
Common Stock | 2,166,229 | I | See(1) |
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 Preferred Stock | (5) | (6) | Common Stock | 4,500,000 | (2) | I | See(1) |
Series B Preferred Stock | (5) | (6) | Common Stock | 333,333 | (3) | I | See(1) |
Series C Preferred Stock | (5) | (6) | Common Stock | 4,000,000 | (4) | I | See(1) |
Explanation of Responses: |
1. President (BVI) International Investment Holdings, Ltd, or PILH, is a wholly-owned subsidiary of President International Development Corporation, or PIDC, which is a 61% owned subsidiary of Uni-President Enterprises Corp, or Uni-President, a Republic of China company publicly traded on the Taiwan Stock Exchange. Mr. Tu, one of the Issuer's directors, is the President PIDC. Thirteen individuals, who comprise the Board of Directors and supervisors of Uni-President, may be deemed to share dispositive and voting power over the shares owned by PILH. Each of the thirteen individuals disclaims beneficial ownership of such shares, except to the extent of his or her pecuniary interest therein. |
2. Each 1 share of Series A Preferred Stock converts into approximately 1.5188208 shares of Common Stock. |
3. Each 1 share of Series B Preferred Stock converts into 7.5 shares of Common Stock. |
4. Each 1 share of Series C Preferred Stock converts into 1 share of Common Stock. |
5. Accuray's Preferred Stock may be converted into shares of Common Stock, at the applicable conversion ratio, at the election of such Preferred stockholder at any time. All shares of Accuray's Preferred Stock automatically convert into shares of Common Stock, at the applicable conversion ratio, at the Closing of Accuray's Initial Public Offering. |
6. Not applicable. |
/s/ Lori Rognstad by Power of Attorney | 02/08/2007 | |
** 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. |