0001209191-23-038439.txt : 20230620 0001209191-23-038439.hdr.sgml : 20230620 20230620164509 ACCESSION NUMBER: 0001209191-23-038439 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230616 FILED AS OF DATE: 20230620 DATE AS OF CHANGE: 20230620 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Klausner Richard CENTRAL INDEX KEY: 0001591178 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40502 FILM NUMBER: 231025864 MAIL ADDRESS: STREET 1: 5200 ILLUMINA WAY CITY: SAN DIEGO STATE: CA ZIP: 92122 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lyell Immunopharma, Inc. CENTRAL INDEX KEY: 0001806952 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 833006753 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 201 HASKINS WAY CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 BUSINESS PHONE: 650 695-0677 MAIL ADDRESS: STREET 1: 201 HASKINS WAY CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 4 1 doc4.xml FORM 4 SUBMISSION X0407 4 2023-06-16 0 0001806952 Lyell Immunopharma, Inc. LYEL 0001591178 Klausner Richard C/O LYELL IMMUNOPHARMA, INC. 201 HASKINS WAY SOUTH SAN FRANCISCO CA 94080 1 0 0 0 0 Common Stock 2967834 D Common Stock 988900 I Grantor Option (right to buy) 3.19 2023-06-16 4 A 0 65000 0.00 A 2033-06-15 Common Stock 65000 65000 D Consists of 250,000 shares held by The Ariella Klausner Delaware Trust, 238,900 shares held by The Eli Klausner Delaware Trust, 250,000 shares held by The Isaac Klausner Delaware Trust, and 250,000 shares held by The Olivia Klausner Delaware Trust. The Reporting Person is a grantor of each of the trusts and disclaims beneficial ownership of all shares held by the trusts except to any pecuniary interest therein. Raymond James Trust Services of Delaware is the trustee of each of the trusts. The option shares shall vest on the earlier of (a) the date of the next annual meeting of the stockholders that occurs following June 16, 2023 (or the date immediately prior to such date if the Reporting Person's service as a director ends at such annual meeting due to the Reporting Person's failure to be reelected or the Reporting Person not standing for re-election); or (b) the first anniversary of June 16, 2023, subject to the Reporting Person providing continuous service through such date. /s/ Charles Newton, as Attorney-in-fact 2023-06-20