0001447362-22-000068.txt : 20220428 0001447362-22-000068.hdr.sgml : 20220428 20220428192939 ACCESSION NUMBER: 0001447362-22-000068 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220426 FILED AS OF DATE: 20220428 DATE AS OF CHANGE: 20220428 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MAETZOLD DEREK J CENTRAL INDEX KEY: 0001239501 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38984 FILM NUMBER: 22869204 MAIL ADDRESS: STREET 1: 820 S. FRIENDSWOOD DRIVE STREET 2: SUITE 201 CITY: FRIENDSWOOD STATE: TX ZIP: 77546 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CASTLE BIOSCIENCES INC CENTRAL INDEX KEY: 0001447362 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 770701774 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 505 S FRIENDSWOOD DRIVE STREET 2: SUITE 401 CITY: FRIENDSWOOD STATE: TX ZIP: 77546 BUSINESS PHONE: 866-788-9007 MAIL ADDRESS: STREET 1: 505 S FRIENDSWOOD DRIVE STREET 2: SUITE 401 CITY: FRIENDSWOOD STATE: TX ZIP: 77546 4 1 wf-form4_165118849087804.xml FORM 4 X0306 4 2022-04-26 0 0001447362 CASTLE BIOSCIENCES INC CSTL 0001239501 MAETZOLD DEREK J C/O CASTLE BIOSCIENCES, INC. 505 S. FRIENDSWOOD DRIVE, SUITE 401 FRIENDSWOOD TX 77546 1 1 0 0 Pres. & Chief Exec. Officer Common Stock 2022-04-26 4 A 0 22311 A 201934 D Common Stock 55603 I By DJM Grantor Retained Annuity Trust No. 2 Common Stock 75000 I By DJM Grantor Retained Annuity Trust No. 3 Common Stock 137965 I By Derek Maetzold 2020 Irrevocable Trust Common Stock 150567 I By The Maetzold Descendants 2020 Trust Common Stock 30545 I By The Maetzold 2018 Remainder Trust FBO Hannah Elizabeth Maetzold Common Stock 30545 I By The Maetzold 2018 Remainder Trust FBO Peter Douglas Maetzold Common Stock 30546 I By The Maetzold 2018 Remainder Trust FBO Emily Carol Kirk Common Stock 30545 I By The Maetzold 2018 Remainder Trust FBO John Derek Maetzold The reporting person acquired 22,311 shares of common stock on April 26, 2022, as consideration for the Reporting Person's equity securities of AltheaDx, Inc. ("AltheaDx"), which Castle Biosciences, Inc. ("Castle Biosciences") acquired by merger on April 26, 2022 (the "Merger") pursuant to an Agreement and Plan of Merger agreement dated April 4, 2022 (the "Merger Agreement"). Of the 22,311 shares issued to the Reporting Person in the Merger, 1,895 shares are currently being held in escrow and are subject to forfeiture for a specified period following the Merger to satisfy indemnification claims arising of Castle Biosciences, if any. The Merger Agreement provides that the former securityholders of AltheaDx may receive additional consideration, payable 50% in cash and 50% in shares of common stock of Castle Biosciences, based on the achievement of certain commercial milestones with related dates or performance periods through December 31, 2024 (the "Milestone Payments"). The portion of the Milestone Payments payable in shares of common stock will be valued at the volume-weighted average price for the 20 trading days ending as of the applicable determination date. The number of shares issuable is subject to certain limitations set forth in the Merger Agreement. The Reporting Person's right to receive additional shares pursuant to this earn-out right became fixed and irrevocable on April 26, 2022, the effective date of the merger. The number of shares issuable was determined pursuant to a formula set forth in the Merger Agreement, which provided that, for the purpose of determining the number of shares issuable, the shares of Castle Biosciences common stock would be valued at $42.54, which represents the volume weighted average share price of the stock for the 20 trading days immediately preceding the date of the Merger Agreement. On March 2, 2022, and March 3, 2022, the DJM Grantor Retained Annuity Trust No. 2 made annuity payments to the Reporting Person by transferring a total of 44,397 shares of Castle Biosciences, Inc. common stock to his direct holdings. Held by DJM Grantor Retained Annuity Trust No. 2 of which the Reporting Person is the trustee and beneficiary. Held by DJM Grantor Retained Annuity Trust No. 3 of which the Reporting Person is the trustee and beneficiary. Held by Derek Maetzold 2020 Irrevocable Trust of which the Reporting Person is the trustee and his children are beneficiaries. Held by The Maetzold Descendants 2020 Trust of which the Reporting Person's spouse is the trustee and the Reporting Person's spouse and their children are beneficiaries. Held by The Maetzold 2018 Remainder Trust FBO Hannah Elizabeth Maetzold of which the Reporting Person is the trustee and his child is the beneficiary. Held by The Maetzold 2018 Remainder Trust FBO Peter Douglas Maetzold of which the Reporting Person is the trustee and his child is the beneficiary. Held by The Maetzold 2018 Remainder Trust FBO Emily Carol Kirk of which the Reporting Person is the trustee and his child is the beneficiary. Held by The Maetzold 2018 Remainder Trust FBO John Derek Maetzold of which the Reporting Person is the trustee and his child is the beneficiary. /s/ Greg Acosta, Attorney-in-fact 2022-04-28