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