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) 03/27/2024 |
3. Issuer Name and Ticker or Trading Symbol
Boundless Bio, Inc. [ BOLD ] |
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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) |
Common Stock | 102,564 | D | |
Common Stock | 25,641 | I | By City Hill, LLC(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 Convertible Preferred Stock | (2) | (2) | Common Stock | 512,820 | (2) | I | By City Hill, LLC(1) |
Series B Convertible Preferred Stock | (2) | (2) | Common Stock | 5,128 | (2) | I | By City Hill, LLC(1) |
Series C Convertible Preferred Stock | (2) | (2) | Common Stock | 7,326 | (2) | I | By City Hill, LLC(1) |
Stock Option | (3) | 06/06/2031 | Common Stock | 10,256 | $4.1 | D | |
Stock Option | (4) | 06/12/2033 | Common Stock | 17,435 | $4.1 | D | |
Stock Option | (5) | 02/14/2034 | Common Stock | 13,846 | $8.19 | D |
Explanation of Responses: |
1. Consists of shares held directly by City Hill, LLC ("City Hill"). Jonathan E. Lim, M.D. serves as the managing partner of City Hill. Dr. Lim exercises voting and dispositive control over the securities held by City Hill and is therefore deemed to be a beneficial owner of securities owned by City Hill. Dr. Lim disclaims beneficial ownership of the reported securities held by City Hill, except to the extent of his pecuniary interest therein. |
2. Each share of the Issuer's preferred stock is convertible into shares of the Issuer's common stock at the holder's election and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering. |
3. The stock option vests in 36 substantially equal monthly installments beginning on July 7, 2021. |
4. The stock option vests in 36 substantially equal monthly installments beginning on July 13, 2023. |
5. The stock option vests in 36 substantially equal monthly installments beginning on March 15, 2024. |
Remarks: |
Exhibit 24 - Power of Attorney. |
/s/ Jessica Oien, Attorney-in-Fact for Jonathan Lim | 03/27/2024 | |
** 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. |