0000950170-24-045110.txt : 20240417
0000950170-24-045110.hdr.sgml : 20240417
20240417161051
ACCESSION NUMBER: 0000950170-24-045110
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240404
FILED AS OF DATE: 20240417
DATE AS OF CHANGE: 20240417
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kutzkey Tim
CENTRAL INDEX KEY: 0001614186
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39635
FILM NUMBER: 24851165
MAIL ADDRESS:
STREET 1: 1700 OWENS STREET
STREET 2: SUITE 500
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94158
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Surrozen, Inc./DE
CENTRAL INDEX KEY: 0001824893
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
ORGANIZATION NAME: 03 Life Sciences
IRS NUMBER: 301374889
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 171 OYSTER POINT BLVD
STREET 2: SUITE 400
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
BUSINESS PHONE: 650-475-2820
MAIL ADDRESS:
STREET 1: 171 OYSTER POINT BLVD
STREET 2: SUITE 400
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
FORMER COMPANY:
FORMER CONFORMED NAME: Consonance-HFW Acquisition Corp.
DATE OF NAME CHANGE: 20200915
4/A
1
ownership.xml
4/A
X0508
4/A
2024-04-04
2024-04-08
0001824893
Surrozen, Inc./DE
SRZN
0001614186
Kutzkey Tim
C/O SURROZEN, INC.
171 OYSTER POINT BLVD., SUITE 400
SOUTH SAN FRANCISCO
CA
94080
true
false
true
false
false
Common Stock
2024-04-04
4
P
false
90897
15.5
A
289549
I
By The Column Group III, LP
Common Stock
2024-04-04
4
P
false
102651
15.5
A
326992
I
By The Column Group III-A, LP
Represents a price per unit, consisting of (i) $14.25 per share of the Issuer's Common Stock and (ii) $1.25 attributable to accompanying warrants to purchase shares of the Issuer's Common Stock, which The Column Group III, LP ("TCG III LP") and The Column Group III-A, LP ("TCG III-A LP") purchased in the Issuer's private placement on April 4, 2024.
This Form 4/A is being filed to correct the amount beneficially owned, which was misreported in the original Form 4 filed on April 8, 2024 due to an administrative error.
The securities are directly held by TCG III LP. The Column Group III GP, LP ("TCG III GP") is the general partner of TCG III LP and may be deemed to have voting, investment and dispositive power with respect to these securities. The managing partners of TCG III GP are David Goeddel, Peter Svennilson and the Reporting Person, a member of the Issuer's board of directors (collectively, the "Managing Partners"). The Managing Partners may be deemed to share voting and investment power with respect to such securities. TCG III GP and each of the Managing Partners disclaim beneficial ownership of these securities, except to the extent of their respective pecuniary interest in such securities.
The securities are directly held by TCG III-A LP. TCG III GP is the general partner of TCG III-A LP and may be deemed to have voting, investment and dispositive power with respect to these securities. The managing partners of TCG III GP are the Managing Partners. The Managing Partners may be deemed to share voting and investment power with respect to such securities. TCG III GP and each of the Managing Partners disclaim beneficial ownership of these securities, except to the extent of their respective pecuniary interest in such securities.
/s/James Evangelista, as attorney-in-fact for Tim Kutzkey
2024-04-17