0001209191-21-065892.txt : 20211119
0001209191-21-065892.hdr.sgml : 20211119
20211119173550
ACCESSION NUMBER: 0001209191-21-065892
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211117
FILED AS OF DATE: 20211119
DATE AS OF CHANGE: 20211119
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lee Frank D.
CENTRAL INDEX KEY: 0001814686
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39988
FILM NUMBER: 211429555
MAIL ADDRESS:
STREET 1: C/O FORMA THERAPEUTICS HOLDINGS, INC.
STREET 2: 500 ARSENAL STREET, SUITE 100
CITY: WATERTOWN
STATE: MA
ZIP: 02472
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Bolt Biotherapeutics, Inc.
CENTRAL INDEX KEY: 0001641281
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 472804636
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 900 CHESAPEAKE DRIVE
CITY: REDWOOD CITY
STATE: CA
ZIP: 94063
BUSINESS PHONE: 650-665-9295
MAIL ADDRESS:
STREET 1: 900 CHESAPEAKE DRIVE
CITY: REDWOOD CITY
STATE: CA
ZIP: 94063
FORMER COMPANY:
FORMER CONFORMED NAME: Bolt Therapeutics, Inc.
DATE OF NAME CHANGE: 20150504
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-11-17
0
0001641281
Bolt Biotherapeutics, Inc.
BOLT
0001814686
Lee Frank D.
C/O BOLT BIOTHERAPEUTICS, INC.
900 CHESAPEAKE DRIVE
REDWOOD CITY
CA
94063
1
0
0
0
Stock Option (Right to Buy)
9.01
2021-11-17
4
A
0
27860
0.00
A
2031-11-16
Common Stock
27860
27860
D
The shares subject to this option shall vest in equal monthly installments, at a rate of 1/36th of the total number of shares on each monthly anniversary of November 17, 2021 (the "Vesting Commencement Date") for so long as the Reporting Person provides continuous service to the Issuer, such that the total number of shares shall be fully vested on the three-year anniversary of the Vesting Commencement Date; provided, however that the option will vest in full upon a change in control of the Issuer.
/s/ Brian Woodard, Attorney-in-Fact
2021-11-19