0001209191-19-049967.txt : 20190917 0001209191-19-049967.hdr.sgml : 20190917 20190917204718 ACCESSION NUMBER: 0001209191-19-049967 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20190917 FILED AS OF DATE: 20190917 DATE AS OF CHANGE: 20190917 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Topsoe Jakob Haldor CENTRAL INDEX KEY: 0001785882 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39045 FILM NUMBER: 191098234 MAIL ADDRESS: STREET 1: 325 E MIDDLEFIELD ROAD CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IGM Biosciences, Inc. CENTRAL INDEX KEY: 0001496323 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 770349194 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 325 E MIDDLEFIELD ROAD CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 BUSINESS PHONE: 650-965-7873 MAIL ADDRESS: STREET 1: 325 E MIDDLEFIELD ROAD CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 FORMER COMPANY: FORMER CONFORMED NAME: Palingen, Inc. DATE OF NAME CHANGE: 20100712 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2019-09-17 0 0001496323 IGM Biosciences, Inc. IGMS 0001785882 Topsoe Jakob Haldor C/O IGM BIOSCIENCES, INC. 325 E. MIDDLEFIELD ROAD MOUNTAIN VIEW CA 94043 1 0 1 0 Series B Preferred Stock 0.00 Common Stock 9039453 I See Footnote Series C Preferred Stock 0.00 Non-Voting Common Stock 2269838 I See Footnote The Series B Preferred Stock will automatically convert into shares of Common Stock on a 1-for-1 basis immediately prior to the closing of the Issuer's initial public offering. The Series B Preferred Stock does not have an expiration date. All shares are held directly by Haldor Topsoe Holding A/S (HTH). Mr. Jakob Haldor Topsoe, Ms. Christina Teng Topsoe, Mr. Martin Topsoe and Mr. Emil Oigaard, members of the board of directors of HTH, may be deemed to share voting and investment power with respect to the shares reported herein and disclaim beneficial ownership of such shares, except to the extent of his or her pecuniary interest therein, if any. Mr. Jakob Haldor Topsoe and Ms. Christina Teng Topsoe are members of the Issuer's board of directors. The Series C Preferred Stock will automatically convert into shares of Non-Voting Common Stock on a 1-for-1 basis, pursuant to an election made by the Reporting Person, immediately prior to the closing of the Issuer's initial public offering, and has no expiration date. Each share of Non-Voting Common Stock is convertible at any time at the option of the Reporting Person into one share of Common Stock (subject to a 4.99% beneficial ownership limitation that may be increased or decreased by the Reporting Person) and has no expiration date. /s/ Misbah Tahir, by power of attorney 2019-09-17 EX-24.3_872791 2 poa.txt POA DOCUMENT POWER OF ATTORNEY The undersigned, as a Section 16 reporting person of IGM Biosciences, Inc. (the "Company"), hereby constitutes and appoints Fred Schwarzer and Misbah Tahir, and each of them, as the undersigned's true and lawful attorney-in-fact to: 1. complete and execute Forms 3, 4 and 5 and other forms and all amendments thereto as such attorney-in fact shall in his discretion determine to be required or advisable pursuant to Section 16 of the Securities Exchange Act of 1934 (as amended) and the rules and regulations promulgated thereunder, or any successor laws and regulations, as a consequence of the undersigned's ownership, acquisition or disposition of securities of the Company; and 2. do all acts necessary in order to file such forms with the Securities and Exchange Commission, any securities exchange or national association, the Company and such other person or agency as the attorneys-in-fact shall deem appropriate. The undersigned hereby ratifies and confirms all that said attorneys-in-fact and agents shall do or cause to be done by virtue hereof. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934 (as amended). This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the Company and the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 14th day of August, 2019. JAKOB HALDOR TOPSOE /S/ Jakob Haldor Topsoe