0001209191-20-062390.txt : 20201208 0001209191-20-062390.hdr.sgml : 20201208 20201208204332 ACCESSION NUMBER: 0001209191-20-062390 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201208 FILED AS OF DATE: 20201208 DATE AS OF CHANGE: 20201208 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Thompson Peter A. CENTRAL INDEX KEY: 0001357522 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39756 FILM NUMBER: 201376691 MAIL ADDRESS: STREET 1: C/O ANTHERA PHARMACEUTICALS, INC. STREET 2: 25801 INDUSTRIAL BOULEVARD, SUITE B CITY: HAYWARD STATE: CA ZIP: 94545 FORMER NAME: FORMER CONFORMED NAME: Thompson Peter A DATE OF NAME CHANGE: 20060327 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Silverback Therapeutics, Inc. CENTRAL INDEX KEY: 0001671858 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 811489190 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 500 FAIRVIEW AVENUE NORTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 206-456-2900 MAIL ADDRESS: STREET 1: 500 FAIRVIEW AVENUE NORTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98109 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-12-08 0 0001671858 Silverback Therapeutics, Inc. SBTX 0001357522 Thompson Peter A. C/O SILVERBACK THERAPEUTICS, INC. 500 FAIRVIEW AVENUE N, SUITE 600 SEATTLE WA 98109 1 0 1 0 Common Stock 2020-12-08 4 P 0 238100 21.00 A 507423 I By OrbiMed Private Investments VI, LP Common Stock 2020-12-08 4 C 0 3462737 A 3970160 I By OrbiMed Private Investments VI, LP Common Stock 2020-12-08 4 C 0 2493741 A 6463901 I By OrbiMed Private Investments VI, LP Common Stock 2020-12-08 4 C 0 1055287 A 7519188 I By OrbiMed Private Investments VI, LP Common Stock 2020-12-08 4 P 0 952377 21.00 A 952377 I By OrbiMed Partners Master Fund Limited Common Stock 269323 I By OPI VI -IP HoldCo LLC Series A Preferred Stock 2020-12-08 4 C 0 12857142 0.00 D Common Stock 3462737 0 I By OrbiMed Private Investments VI, LP Series B Preferred Stock 2020-12-08 4 C 0 9259259 0.00 D Common Stock 2493741 0 I By OrbiMed Private Investments VI, LP Series C Preferred Stock 2020-12-08 4 C 0 3918279 0.00 D Common Stock 1055287 0 I By OrbiMed Private Investments VI, LP The shares were purchased in the Issuer's initial public offering. These securities are held of record by OrbiMed Private Investments VI, LP ("OPI VI"). OrbiMed Capital GP VI LLC ("GP VI") is the general partner to OPI VI and OrbiMed Advisors LLC ("OrbiMed Advisors") is the managing member of GP VI. By virtue of such relationships, GP VI and OrbiMed Advisors may be deemed to have voting and investment power with respect to the shares held by OPI VI. Both GP VI and OrbiMed Advisors may be deemed to directly or indirectly, including by reason of their mutual affiliation, to be beneficial owners of the shares held by OPI VI. OrbiMed Advisors exercise investment and voting power through a management committee comprised of Carl L. Gordon, Jonathan T. Silverstein and Sven H. Borho, each of whom disclaims beneficial ownership of the shares of OPI VI. The Reporting Person is the designated representative of OrbiMed Advisors on the Issuer's Board of Directors. The reportable securities are owned indirectly by OPI VI. GP VI is the general partner of OPI VI and OrbiMed Advisors is the managing member of GP VI. The Reporting Person disclaims beneficial ownership of the securities reported herein for the purposes of Rule 16a-1(a) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), except to the extent of his pecuniary interest therein, if any. All outstanding shares of Preferred Stock automatically converted into shares of Common Stock immediately upon the closing of the Issuer's initial public offering, for no additional consideration at a rate of one share of Common Stock for each 3.713 shares of Preferred Stock, based on the conversion price currently in effect. The Preferred Stock has no expiration date. These securities are held of record by OrbiMed Partners Master Fund Limited ("OPM"). OrbiMed Capital LLC ("OrbiMed Capital") is the investment advisor to OPM. OrbiMed Capital is a relying advisor of OrbiMed Advisors. OrbiMed Advisors and OrbiMed Capital exercise voting and investment power through a management committee comprised of Carl L. Gordon, Jonathan T. Silverstein and Sven H. Borho, each of whom disclaims beneficial ownership of the shares held by OPM. These securities are held of record by OPI VI - IP HoldCo LLC ("HoldCo"). OPI VI - IP TopCo LLC ("TopCo") is the sole member of HoldCo. OrbiMed Private Investments VI - IP, LP ("OPI VI IP") is the sole member of TopCo. GP VI is the general partner of OPI VI IP. OrbiMed Advisors is the managing member of GP VI. By virtue of such relationships, OrbiMed Advisors and GP VI may be deemed to have voting and investment power over the securities held by HoldCo and as a result, may be deemed to have beneficial ownership over such securities. Advisors exercises voting and investment power through a management committee comprised of Carl L. Gordon, Jonathan T. Silverstein and Sven H. Borho, each of whom disclaims beneficial ownership of the shares held by HoldCo. /s/ Jeffrey C. Pepe, Attorney-in-Fact 2020-12-08