SEC FORM 3

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^*

Hornblower Josiah

(Last)

(First)

(Middle)

C/O SHATTUCK LABS, INC.

1018 W. 11TH STREET, SUITE 100

(Street)

AUSTIN

78703

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
10/08/2020

3. Issuer Name and Ticker or Trading Symbol
Shattuck Labs, Inc. [ STTK ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	X	10% Owner
X	Officer (give title below)		Other (specify below)
	Chairman

5. 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 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)
Common Stock	3,253,750	I	By Hornblower Capital Holdings, LLC

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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Series A Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	23,488⁽¹⁾	⁽¹⁾	I	By Hornblower Capital Holdings, LLC
Series A Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	63,019⁽¹⁾	⁽¹⁾	I	By Stone Dock Investors
Series B Preferred Stock	⁽²⁾	⁽²⁾	Common Stock	54,471⁽²⁾	⁽²⁾	I	By Hornblower Capital Holdings, LLC
Series B Preferred Stock	⁽²⁾	⁽²⁾	Common Stock	16,337⁽²⁾	⁽²⁾	I	By Stone Dock Investors
Stock Option (Right to Buy)	⁽³⁾	08/05/2030	Common Stock	188,375	$4.67	D

Explanation of Responses:

1. Each share of Series A Preferred Stock is convertible into 6.85 shares of common stock at any time at the holder's election and will convert automatically immediately prior to the closing of the Issuer's initial public offering (the "IPO"). The Series A Preferred Stock has no expiration date.

2. Each share of Series B Preferred Stock is convertible into 6.85 shares of common stock at any time at the holder's election and will convert automatically immediately prior to the closing of the IPO. The Series B Preferred Stock has no expiration date.

3. This option represents a right to purchase a total of 188,375 shares of the Issuer's common stock, one quarter of which will vest on August 6, 2021, with the remaining three quarters vesting in equal monthly installments through August 6, 2024, subject to the Reporting Person's continued service to the Issuer.

Remarks:

Exhibit 24 - Power of Attorney

	/s/ Erin Ator Thomson, Attorney-in-fact for Josiah Hornblower	10/08/2020
	** 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.