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