0001104659-19-036508.txt : 20190619 0001104659-19-036508.hdr.sgml : 20190619 20190619215529 ACCESSION NUMBER: 0001104659-19-036508 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190619 FILED AS OF DATE: 20190619 DATE AS OF CHANGE: 20190619 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LIGHTSPEED VENTURE PARTNERS VIII LP CENTRAL INDEX KEY: 0001435573 STATE OF INCORPORATION: XX FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907373 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-234-8300 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lightspeed General Partner VIII, L.P. CENTRAL INDEX KEY: 0001522569 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907374 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6502348300 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lightspeed Ultimate General Partner VIII, Ltd. CENTRAL INDEX KEY: 0001522568 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907375 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6502348300 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lightspeed Venture Partners Select, L.P. CENTRAL INDEX KEY: 0001602575 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907376 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-233-8300 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lightspeed General Partner Select, L.P. CENTRAL INDEX KEY: 0001700551 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907377 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 234-8300 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER NAME: FORMER CONFORMED NAME: Lightspeed General Partner Select, L,P. DATE OF NAME CHANGE: 20170310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lightspeed Ultimate General Partner Select, Ltd. CENTRAL INDEX KEY: 0001700544 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907378 BUSINESS ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 234-8300 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Eggers Barry CENTRAL INDEX KEY: 0001366048 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907379 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Liew Jeremy CENTRAL INDEX KEY: 0001700539 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907380 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mhatre Ravi CENTRAL INDEX KEY: 0001366050 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907381 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nieh Peter CENTRAL INDEX KEY: 0001366051 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19907382 MAIL ADDRESS: STREET 1: 2200 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Personalis, Inc. CENTRAL INDEX KEY: 0001527753 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 275411038 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1330 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-752-1300 MAIL ADDRESS: STREET 1: 1330 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 3 1 a3.xml 3 X0206 3 2019-06-19 0 0001527753 Personalis, Inc. PSNL 0001435573 LIGHTSPEED VENTURE PARTNERS VIII LP 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001522569 Lightspeed General Partner VIII, L.P. 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001522568 Lightspeed Ultimate General Partner VIII, Ltd. 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001602575 Lightspeed Venture Partners Select, L.P. 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001700551 Lightspeed General Partner Select, L.P. 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001700544 Lightspeed Ultimate General Partner Select, Ltd. 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001366048 Eggers Barry 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001700539 Liew Jeremy 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001366050 Mhatre Ravi 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001366051 Nieh Peter 2200 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 Series A Preferred Stock Common Stock 2317073 I See footnote Series B Preferred Stock Common Stock 978260 I See footnote Series C Preferred Stock Common Stock 822435 I See footnote Series C Preferred Stock Common Stock 1958726 I See footnote The Issuer's preferred stock will automatically convert into an equal number of share of Issuer's common stock immediately upon the closing of the Issuer's initial public offering and has no expiration date. Shares held by Lightspeed Venture Partners VIII, L.P. ("Lightspeed VIII"). Lightspeed General Partner VIII, L.P ("LGP VIII") is the general partner of Lightspeed VIII. Lightspeed Ultimate General Partner VIII, Ltd. ("LUGP VIII") is the general partner of LGP VIII. Barry Eggers, Ravi Mhatre and Peter Nieh are the directors of LUGP VIII and share voting and dispositive power with respect to the shares held by Lightspeed VIII. LGP VIII, LUGP VIII and Messrs. Eggers, Mhatre and Nieh disclaim beneficial ownership of the shares held by Lightspeed VIII except to the extent of their respective pecuniary interests therein. Shares held by Lightspeed Venture Partners Select, L.P. ("Lightspeed Select"). Lightspeed General Partner Select, L.P ("LGP Select") is the general partner of Lightspeed Select. Lightspeed Ultimate General Partner Select, Ltd. ("LUGP Select") is the general partner of LGP Select. Barry Eggers, Jeremy Liew, Ravi Mhatre and Peter Nieh are the directors of LUGP Select and share voting and dispositive power with respect to the shares held by Lightspeed Select. LGP Select, LUGP Select and Messrs. Eggers, Liew, Mhatre and Nieh disclaim beneficial ownership of the shares held by Lightspeed Select except to the extent of their respective pecuniary interests therein. LIGHTSPEED VENTURE PARTNERS VIII, L.P. By: Lightspeed General Partner VIII, L.P., its general partner By: Lightspeed Ultimate General Partner VIII, Ltd., its general partner By: /s/ Ravi Mhatre Duly Authorized Signatory 2019-06-19 LIGHTSPEED GENERAL PARTNER VIII, L.P. By: Lightspeed Ultimate General Partner VIII, Ltd., its general partner By: /s/ Ravi Mhatre Duly Authorized Signatory 2019-06-19 LIGHTSPEED ULTIMATE GENERAL PARTNER VIII, LTD. By: /s/ Ravi Mhatre Duly Authorized Signatory 2019-06-19 LIGHTSPEED VENTURE PARTNERS SELECT, L.P. By: Lightspeed General Partner Select, L.P., its general partner By: Lightspeed Ultimate General Partner Select, Ltd., its general partner By: /s/ Ravi Mhatre Duly Authorized Signatory 2019-06-19 LIGHTSPEED GENERAL PARTNER SELECT, L.P. By: Lightspeed Ultimate General Partner Select, Ltd., its general partner By: /s/ Ravi Mhatre Duly Authorized Signatory 2019-06-19 LIGHTSPEED ULTIMATE GENERAL PARTNER SELECT, LTD. By: /s/ Ravi Mhatre Duly Authorized Signatory 2019-06-19 /s/ Barry Eggers 2019-06-19 /s/ Jeremy Liew 2019-06-19 /s/ Ravi Mhatre 2019-06-19 /s/ Peter Nieh 2019-06-19