0001209191-21-008753.txt : 20210209
0001209191-21-008753.hdr.sgml : 20210209
20210209153335
ACCESSION NUMBER: 0001209191-21-008753
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210209
FILED AS OF DATE: 20210209
DATE AS OF CHANGE: 20210209
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SHAH MAHENDRA
CENTRAL INDEX KEY: 0001255449
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39988
FILM NUMBER: 21606074
MAIL ADDRESS:
STREET 1: 2250 HOLCOMBE BLVD
CITY: HOUSTON
STATE: TX
ZIP: 77030
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Bolt Biotherapeutics, Inc.
CENTRAL INDEX KEY: 0001641281
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 472804636
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 900 CHESAPEAKE DRIVE
CITY: REDWOOD CITY
STATE: CA
ZIP: 94063
BUSINESS PHONE: 650-665-9295
MAIL ADDRESS:
STREET 1: 900 CHESAPEAKE DRIVE
CITY: REDWOOD CITY
STATE: CA
ZIP: 94063
FORMER COMPANY:
FORMER CONFORMED NAME: Bolt Therapeutics, Inc.
DATE OF NAME CHANGE: 20150504
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-02-09
0
0001641281
Bolt Biotherapeutics, Inc.
BOLT
0001255449
SHAH MAHENDRA
C/O BOLT BIOTHERAPEUTICS, INC.
900 CHESAPEAKE DRIVE
REDWOOD CITY
CA
94063
1
0
0
0
Common Stock
2021-02-09
4
C
0
944056
A
958341
I
By Vivo PANDA Fund, L.P.
Common Stock
2021-02-09
4
C
0
472296
A
1430637
I
By Vivo PANDA Fund, L.P.
Common Stock
2021-02-09
4
X
0
17711
0.07
A
1448348
I
By Vivo PANDA Fund, L.P.
Common Stock
2021-02-09
4
S
0
62
20.00
D
1448286
I
By Vivo PANDA Fund, L.P.
Series A- 1 Preferred Stock
2021-02-09
4
C
0
944056
0.00
D
Common Stock
944056
0
I
By Vivo PANDA Fund, L.P.
Series B Preferred Stock
2021-02-09
4
C
0
472296
0.00
D
Common Stock
472296
0
I
By Vivo PANDA Fund, L.P.
Warrant (Right to Buy)
0.07
2021-02-09
4
X
0
17711
0.00
D
2028-07-26
Common Stock
17711
0
I
By Vivo PANDA Fund, L.P.
The Series A-1 Preferred Stock automatically converted into shares of Common Stock of the Issuer on a 1:1 basis immediately upon closing of the Issuer's initial public offering (the "IPO") and had no expiration date.
The securities reported herein are held of record by Vivo PANDA Fund, L.P. ("Vivo LP"). Vivo Panda, LLC ("Vivo LLC") is the sole general partner of Vivo LP. The Reporting Person is a managing member of Vivo LLC and has shared voting and investment power over the securities beneficially owned by Vivo LP and may therefore be deemed to have or share beneficial ownership of the securities held directly by Vivo LP. The Reporting Person disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein.
The Series B Preferred Stock automatically converted into shares of Common Stock of the Issuer on a 1:1 basis immediately upon closing of the Issuer's IPO and had no expiration date.
Upon closing of the Issuer's IPO, Vivo LP exercised a warrant to purchase 17,711 shares of the Issuer's Common Stock at an exercise price per share of $0.07. Vivo LP paid the exercise price on a cashless basis, resulting in the Issuer withholding 62 share subject to the warrant in order to pay the exercise price and issuing to Vivo LP the remaining 17,649 shares of Common Stock.
The shares subject to this warrant were fully vested prior to exercise.
/s/ Brian Woodard, Attorney-in-Fact
2021-02-09