0001104659-21-094519.txt : 20210721
0001104659-21-094519.hdr.sgml : 20210721
20210721180156
ACCESSION NUMBER: 0001104659-21-094519
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210719
FILED AS OF DATE: 20210721
DATE AS OF CHANGE: 20210721
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CRITCHFIELD GREGORY C
CENTRAL INDEX KEY: 0001191080
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40606
FILM NUMBER: 211105450
MAIL ADDRESS:
STREET 1: 320 WAKARA WAY
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84108
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SERA PROGNOSTICS, INC.
CENTRAL INDEX KEY: 0001534969
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071]
IRS NUMBER: 261911522
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2749 E. PARLEYS WAY
STREET 2: SUITE 200
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84109
BUSINESS PHONE: (801) 990-0520
MAIL ADDRESS:
STREET 1: 2749 E. PARLEYS WAY
STREET 2: SUITE 200
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84109
4
1
tm2122781-3_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-07-19
0
0001534969
SERA PROGNOSTICS, INC.
SERA
0001191080
CRITCHFIELD GREGORY C
C/O SERA PROGNOSTICS, INC.
2749 EAST PARLEYS WAY, SUITE 200
SALT LAKE CITY
UT
84109
1
1
0
0
Chief Executive Officer
Class A Common Stock
2021-07-19
4
C
0
34383
A
744355
D
Class A Common Stock
2021-07-19
4
C
0
5253
A
749608
D
Class A Common Stock
2021-07-19
4
C
0
11880
A
761488
D
Class A Common Stock
2021-07-19
4
C
0
4727
A
766215
D
Class A Common Stock
2021-07-19
4
C
0
28730
A
794945
D
Series A-2 Preferred Stock
2021-07-19
4
C
0
34383
0
D
Class A Common Stock
34383
0
D
Series B-1 Preferred Stock
2021-07-19
4
C
0
5253
0
D
Class A Common Stock
5253
0
D
Series B-2 Preferred Stock
2021-07-19
4
C
0
11880
0
D
Class A Common Stock
11880
0
D
Series C-1 Preferred Stock
2021-07-19
4
C
0
4727
0
D
Class A Common Stock
4727
0
D
Series D Preferred Stock
2021-07-19
4
C
0
28730
0
D
Class A Common Stock
28730
0
D
The Issuer's Series A-2 Preferred Stock is convertible at the option of a holder at any time into shares of the Issuer's Class A Common Stock at a conversion price, as adjusted to reflect the Issuer's recent 1-for-0.481 reverse stock split, of $5.20 per share. The Series A-2 Preferred Stock has no expiration date.
Includes 630,832 shares of Class A Common Stock directly held by The Gregory C. Critchfield & Trust. Dr. Critchfield is a Trustee of the Gregory C. Critchfield & Trust. Dr. Critchfield, in such capacity, may be deemed to indriectly beneficially own the securities owned by the trust except to the extent of his pecuniary interest therein, if any.
The Issuer's Series B-1 Preferred Stock is convertible at the option of a holder at any time into shares of the Issuer's Class A Common Stock at a conversion price, as adjusted to reflect the Issuer's recent 1-for-0.481 reverse stock split, of $5.20 per share. The Series B-1 Preferred Stock has no expiration date.
The Issuer's Series B-2 Preferred Stock is convertible at the option of a holder at any time into shares of the Issuer's Class A Common Stock at a conversion price, as adjusted to reflect the Issuer's recent 1-for-0.481 reverse stock split, of $8.32 per share. The Series B-2 Preferred Stock has no expiration date.
The Issuer's Series C-1 Preferred Stock is convertible at the option of a holder at any time into shares of the Issuer's Class A Common Stock at a conversion price, as adjusted to reflect the Issuer's recent 1-for-0.481 reverse stock split, of $12.37 per share. The Series C-1 Preferred Stock has no expiration date.
The Issuer's Series D Preferred Stock is convertible at the option of a holder at any time into shares of the Issuer's Class A Common Stock at a conversion price, as adjusted to reflect the Issuer's recent 1-for-0.481 reverse stock split, of $9.02 per share. The Series D Preferred Stock has no expiration date.
The shares of preferred stock automatically converted into the Issuer's Class A Common Stock in accordance with the Issuer's Restated Certificate of Incorporation, as amended, immediately upon completion of the Issuer's initial public offering, which became effective on July 19, 2021.
/s/ Nishanti Dharia, Attorney-in-fact
2021-07-21