0001387131-20-010839.txt : 20201210
0001387131-20-010839.hdr.sgml : 20201210
20201210200849
ACCESSION NUMBER: 0001387131-20-010839
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201210
FILED AS OF DATE: 20201210
DATE AS OF CHANGE: 20201210
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shabet Rose Sharon
CENTRAL INDEX KEY: 0001711393
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 201381926
MAIL ADDRESS:
STREET 1: C/O VIKING GLOBAL INVESTORS LP
STREET 2: 280 PARK AVENUE
CITY: NEW YORK
STATE: NY
ZIP: 10017
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ott David C.
CENTRAL INDEX KEY: 0001621842
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 201381927
MAIL ADDRESS:
STREET 1: C/O VIKING GLOBAL INVESTORS LP
STREET 2: 280 PARK AVENUE
CITY: NEW YORK
STATE: NY
ZIP: 10017
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HALVORSEN OLE ANDREAS
CENTRAL INDEX KEY: 0001133006
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 201381928
MAIL ADDRESS:
STREET 1: C/O VIKING GLOBAL INVESTORS LP
STREET 2: 280 PARK AVE 35TH
CITY: NEW YORK
STATE: NY
ZIP: 10017
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Viking Global Opportunities GP LLC
CENTRAL INDEX KEY: 0001629476
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 201381929
BUSINESS ADDRESS:
STREET 1: 55 RAILROAD AVENUE
CITY: GREENWICH
STATE: CT
ZIP: 06830
BUSINESS PHONE: 203-863-5000
MAIL ADDRESS:
STREET 1: 55 RAILROAD AVENUE
CITY: GREENWICH
STATE: CT
ZIP: 06830
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Viking Global Opportunities Portfolio GP LLC
CENTRAL INDEX KEY: 0001629472
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 201381930
BUSINESS ADDRESS:
STREET 1: 55 RAILROAD AVENUE
CITY: GREENWICH
STATE: CT
ZIP: 06830
BUSINESS PHONE: 203-863-5000
MAIL ADDRESS:
STREET 1: 55 RAILROAD AVENUE
CITY: GREENWICH
STATE: CT
ZIP: 06830
FORMER NAME:
FORMER CONFORMED NAME: VGO Portfolio GP LLC
DATE OF NAME CHANGE: 20141230
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Viking Global Opportunities Illiquid Investments Sub-Master LP
CENTRAL INDEX KEY: 0001629482
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 201381931
BUSINESS ADDRESS:
STREET 1: MORGAN STANLEY SERVICES (CAYMAN)
STREET 2: CRICKET SQ., HUTCHINS DR., P.O. BOX 2681
CITY: GRAND CAYMAN
STATE: E9
ZIP: KY1-1111
BUSINESS PHONE: 441-295-9166
MAIL ADDRESS:
STREET 1: MORGAN STANLEY SERVICES (CAYMAN)
STREET 2: CRICKET SQ., HUTCHINS DR., P.O. BOX 2681
CITY: GRAND CAYMAN
STATE: E9
ZIP: KY1-1111
FORMER NAME:
FORMER CONFORMED NAME: VGO Illiquid Investments Sub-Master LP
DATE OF NAME CHANGE: 20141230
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: VIKING GLOBAL INVESTORS LP
CENTRAL INDEX KEY: 0001103804
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 201381932
BUSINESS ADDRESS:
STREET 1: 55 RAILROAD AVENUE
CITY: GREENWICH
STATE: CT
ZIP: 06830
BUSINESS PHONE: 212-672-7050
MAIL ADDRESS:
STREET 1: 55 RAILROAD AVENUE
CITY: GREENWICH
STATE: CT
ZIP: 06830
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: 4D Molecular Therapeutics Inc.
CENTRAL INDEX KEY: 0001650648
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 473506994
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: 5105052680
MAIL ADDRESS:
STREET 1: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
FORMER COMPANY:
FORMER CONFORMED NAME: 4D Molecular Therapeutics Inc
DATE OF NAME CHANGE: 20150811
3
1
ownership.xml
OWNERSHIP DOCUMENT
X0206
3
2020-12-10
0
0001650648
4D Molecular Therapeutics Inc.
FDMT
0001103804
VIKING GLOBAL INVESTORS LP
55 RAILROAD AVENUE
GREENWICH
CT
06830
0
0
1
0
0001629482
Viking Global Opportunities Illiquid Investments Sub-Master LP
55 RAILROAD AVENUE
GREENWICH
CT
06830
0
0
1
0
0001629472
Viking Global Opportunities Portfolio GP LLC
55 RAILROAD AVENUE
GREENWICH
CT
06830
0
0
1
0
0001629476
Viking Global Opportunities GP LLC
55 RAILROAD AVENUE
GREENWICH
CT
06830
0
0
1
0
0001133006
HALVORSEN OLE ANDREAS
55 RAILROAD AVENUE
GREENWICH
CT
06830
0
0
1
0
0001621842
Ott David C.
55 RAILROAD AVENUE
GREENWICH
CT
06830
0
0
1
0
0001711393
Shabet Rose Sharon
55 RAILROAD AVENUE
GREENWICH
CT
06830
0
0
1
0
Series B Redeemable Convertible Preferred Stock
Common Stock
2004581
I
See Explanation of Responses
Series C Redeemable Convertible Preferred Stock
Common Stock
833333
I
See Explanation of Responses
Andreas Halvorsen, David C. Ott and Rose S. Shabet are Executive Committee members of certain management entities, including Viking Global Partners LLC, the general partner of Viking Global Investors LP ("VGI") and Viking Global Opportunities GP LLC ("Opportunities GP"), the sole owner of Viking Global Opportunities Portfolio GP LLC ("Opportunities Portfolio GP"). VGI provides managerial services to various investment funds, including Viking Global Opportunities Illiquid Investments Sub-Master LP ("Opportunities Fund"). Each of VGI, Opportunities GP, Opportunities Portfolio GP, VGOL, Opportunities Fund, Mr. Halvorsen, Mr. Ott and Ms. Shabet (collectively the "Reporting Persons") may be deemed to beneficially own the shares reported on this form.
VGI provides managerial services to Opportunities Fund, which directly holds the 2,837,914 shares of Common Stock reported herein. Because of the relationship between VGI and VGOP, VGI may be deemed to beneficially own the shares of Common Stock held directly by Opportunities Fund.
Opportunities Portfolio GP is the general partner of Opportunities Fund. Because of the relationship between Opportunities Portfolio GP and Opportunities Fund, Opportunities Portfolio GP may be deemed to beneficially own the shares of Common Stock held directly by Opportunities Fund. Opportunities GP is the sole owner of Opportunities Portfolio GP. Because of the relationship between Opportunities GP and Opportunities Portfolio GP, Opportunities GP may be deemed to beneficially own the shares of Common Stock held directly by Opportunities Fund.
The Reporting Persons disclaim beneficial ownership of these securities except to the extent of their pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), or for any other purpose.
The Series B Redeemable Convertible Preferred Stock is convertible into Common Stock on a one-for-one basis into the number of shares of Common Stock at the Reporting Person's election and automatically upon the closing of the initial public offering of 4D Molecular Therapeutics, Inc. (the "Issuer"). The shares have no expiration date.
The Series C Redeemable Convertible Preferred Stock is convertible into Common Stock on a one-for-one basis into the number of shares of Common Stock at the Reporting Person's election and automatically upon the closing of the initial public offering of the Issuer. The shares have no expiration date.
7. The Reporting Persons are jointly filing this Form 3 pursuant to Rule 16a-3(j) under the Exchange Act. 8. Each of O. Andreas Halvorsen, David C. Ott and Rose S. Shabet is signing individually and as an Executive Committee Member of VIKING GLOBAL PARTNERS LLC, on behalf of VIKING GLOBAL INVESTORS LP, and as an Executive Committee Member of VIKING GLOBAL OPPORTUNITIES GP LLC, on behalf of itself and VIKING GLOBAL OPPORTUNITIES PORTFOLIO GP LLC and VIKING GLOBAL OPPORTUNITIES ILLIQUID INVESTMENTS SUB-MASTER LP.
/s/ O. Andreas Halvorsen (7) (8)
2020-12-10
/s/ David C. Ott (7) (8)
2020-12-10
/s/ Rose S. Shabet (7) (8)
2020-12-10