SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
LALANDE KEVIN M.

(Last) (First) (Middle)
C/O SANTE VENTURES
201 WEST 5TH STREET, SUITE 1500

(Street)
AUSTIN TX 78701

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Molecular Templates, Inc. [ MTEM ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
04/02/2024
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 04/02/2024 A 175,000 A $2.35 175,000 I By SHV MTEM SPV, LLC(1)
Common Stock 406,486 I By Sante Health Ventures I, L.P.(2)
Common Stock 3,333 I By SHV Management Services, L.P.(3)
Common Stock 57,644 I By Sante Health Ventures I Annex Fund, L.P.(4)
Common Stock 14,800 I By SHVMS, LLC(5)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Pre-Funded Warrants (Right to Buy) $0.001 04/02/2024 A 402,077 (6) (6) Common Stock 402,077 $2.349 402,077 I By SHV MTEM SPV, LLC(1)
Warrants (Right to Buy) $2.35 04/02/2024 A 1,154,154 (7) 04/02/2029 Common Stock 1,154,154 $0.125 1,154,154 I By SHV MTEM SPV, LLC(1)
Explanation of Responses:
1. The securities are held by SHV MTEM SPV, LLC ("SHV SPV"). Sante Accel Ventures IV, LLC ("Accel IV") is the managing member of SHV SPV, Sante Health Ventures IV, L.P. ("SHV IV") is the managing member of Accel IV, SHV Management Services IV, LP ("SHV IV Services") is the general partner of SHV IV and SHV Management Services IV, LLC ("SHV IV Management") is the general partner of SHV IV Services. The Reporting Person is a managing member of SHV IV Management and may be deemed to beneficially own the securities held by SHV SPV. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
2. The securities are held by Sante Health Ventures I, L.P. ("SHV I"). SHV Management Services, LP ("SHV Services") is the general partner of SHV I and SHV Management Services, LLC ("SHV Management") is the general partner of SHV Services. The Reporting Person is a managing member of SHV Management and may be deemed to beneficially own the securities held by SHV I. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
3. The securities are held by SHV Services. SHV Management is the general partner of SHV Services. The Reporting Person is a managing member of SHV Management and may be deemed to beneficially own the securities held by SHV Services. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
4. The securities are held by Sante Health Ventures I Annex Fund, L.P. ("Annex Fund"). SHV Annex Services, LP ("Annex Services") is the general partner of Annex Fund and SHV Management is the general partner of Annex Services. The Reporting Person is a managing member of SHV Management and may be deemed to beneficially own the securities held by Annex Fund. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
5. The securities are held by SHVMS, LLC ("SHVMS"). The Reporting Person is a managing member of SHVMS and may be deemed to beneficially own the securities held by SHVMS. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
6. The Pre-Funded Warrants have no expiration date and are exercisable at any time after the date of issuance. A holder of Pre-Funded Warrants may not exercise the Pre-Funded Warrant if the holder, together with its affiliates, would beneficially own more than 9.99% of the number of shares of Common Stock outstanding immediately after giving effect to such exercise.
7. The Warrants are exercisable at any time after the date of issuance. A holder of Warrants may not exercise the Warrant if the holder, together with its affiliates, would beneficially own more than 9.99% of the number of shares of Common Stock outstanding immediately after giving effect to such exercise.
/s/ Kevin Lalande 04/04/2024
** 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 4 (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.