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