0001209191-19-050412.txt : 20190920 0001209191-19-050412.hdr.sgml : 20190920 20190920211353 ACCESSION NUMBER: 0001209191-19-050412 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190918 FILED AS OF DATE: 20190920 DATE AS OF CHANGE: 20190920 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Topsoe Christina Teng CENTRAL INDEX KEY: 0001786442 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39045 FILM NUMBER: 191106160 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-09-18 0 0001496323 IGM Biosciences, Inc. IGMS 0001786442 Topsoe Christina Teng C/O IGM BIOSCIENCES, INC. 325 E. MIDDLEFIELD ROAD MOUNTAIN VIEW CA 94043 1 0 1 0 Common Stock 2019-09-18 4 P 0 34375 16.00 A 34375 D Common Stock 2019-09-18 4 P 0 1250000 16.00 A 1250000 I See footnote Common Stock 2019-09-20 4 C 0 9039453 0.00 A 10289453 I See footnote Series B Preferred Stock 2019-09-20 4 C 0 9039453 0.00 D Common Stock 9039453 0 I See footnote Series C Preferred Stock 2019-09-20 4 C 0 2269838 0.00 D Non-Voting Common Stock 2269838 0 I See footnote Non-Voting Common Stock 2019-09-20 4 C 0 2269838 0.00 A Common Stock 2269838 2269838 I See footnote 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 B Preferred Stock automatically converted 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 had no expiration date. The Series C Preferred Stock automatically converted 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 had 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 2019-09-20