0001387131-21-006822.txt : 20210623 0001387131-21-006822.hdr.sgml : 20210623 20210623181459 ACCESSION NUMBER: 0001387131-21-006822 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210621 FILED AS OF DATE: 20210623 DATE AS OF CHANGE: 20210623 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GLAXOSMITHKLINE PLC CENTRAL INDEX KEY: 0001131399 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] STATE OF INCORPORATION: X0 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40502 FILM NUMBER: 211039711 BUSINESS ADDRESS: STREET 1: 980 GREAT WEST ROAD CITY: BRENTFORD MIDDLESEX STATE: X0 ZIP: TW8 9GS BUSINESS PHONE: 011442080475000 MAIL ADDRESS: STREET 1: 980 GREAT WEST ROAD CITY: BRENTFORD MIDDLESEX STATE: X0 ZIP: TW8 9GS ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lyell Immunopharma, Inc. CENTRAL INDEX KEY: 0001806952 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 833006753 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 EAST JAMIE COURT STREET 2: SUITE 301 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 BUSINESS PHONE: 650 695-0677 MAIL ADDRESS: STREET 1: 400 EAST JAMIE COURT STREET 2: SUITE 301 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 4 1 gsk-form4_062121.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0306 4 2021-06-21 0 0001806952 Lyell Immunopharma, Inc. LYEL 0001131399 GLAXOSMITHKLINE PLC 980 GREAT WEST ROAD BRENTFORD MIDDLESEX X0 TW8 9GS UNITED KINGDOM 0 0 1 0 Common Stock 2021-06-21 4 C 0 30253189 A 30253189 I See Footnote Series AA Preferred Stock 2021-06-21 4 C 0 30253189 D Common Stock 30253189 0 I See Footnote The Series AA Preferred Stock automatically converted into common stock on a 1-for-1 basis into the number of shares of common stock shown in Column 7 without payment of further consideration upon closing of the initial public offering of the Issuer's common stock. The shares had no expiration date. The shares reported herein are held of record by Glaxo Group Limited, an indirect, wholly-owned subsidiary of GlaxoSmithKline plc (the "Reporting Person"). /s/ Victoria A. Whyte 2021-06-23