0001567619-20-021287.txt : 20201217
0001567619-20-021287.hdr.sgml : 20201217
20201217173931
ACCESSION NUMBER: 0001567619-20-021287
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201215
FILED AS OF DATE: 20201217
DATE AS OF CHANGE: 20201217
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: YAO TONY DUNG LING
CENTRAL INDEX KEY: 0001771680
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 201397233
MAIL ADDRESS:
STREET 1: C/O PRECISION BIOSCIENCES, INC.
STREET 2: 302 EAST PETTIGREW STREET, SUITE A-100
CITY: DURHAM
STATE: NC
ZIP: 27701
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: 4D Molecular Therapeutics Inc.
CENTRAL INDEX KEY: 0001650648
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 473506994
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: 5105052680
MAIL ADDRESS:
STREET 1: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
FORMER COMPANY:
FORMER CONFORMED NAME: 4D Molecular Therapeutics Inc
DATE OF NAME CHANGE: 20150811
4
1
doc1.xml
FORM 4
X0306
4
2020-12-15
0
0001650648
4D Molecular Therapeutics Inc.
FDMT
0001771680
YAO TONY DUNG LING
C/O 4D MOLECULAR THERAPEUTICS INC.
5858 HORTON STREET #455
EMERYVILLE
CA
94608
1
0
0
0
Common Stock
2020-12-15
4
C
0
2864
A
2864
D
Common Stock
2020-12-15
4
C
0
455326
A
455326
I
See Footnote
Common Stock
2020-12-15
4
C
0
180554
A
635880
I
See Footnote
Common Stock
2020-12-15
4
P
0
425000
23
A
1060880
I
See Footnote
Series B Preferred Stock
2020-12-15
4
C
0
2864
0.00
D
Common Stock
2864
0
D
Series B Preferred Stock
2020-12-15
4
C
0
455326
0.00
D
Common Stock
455326
0
I
See Footnote
Series C Preferred Stock
2020-12-15
4
C
0
180554
0.00
D
Common Stock
180554
0
I
See Footnote
The Series B Preferred Stock automatically converted into shares of Common Stock on a 1:1 basis immediately upon the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
These securities are held of record by ArrowMark Life Science Fund, LP, ArrowMark Fundamental Opportunity Fund L.P., CF Ascent LLC, Iron Horse Investments, LLC, Lookfar Investments, LLC, Meridian Small Cap Growth Fund and THB Iron Rose, LLC Life Science Portfolio (together, the "ArrowMark Funds"). ArrowMark Colorado Holdings LLC ("ArrowMark Colorado") is an investment advisor to the ArrowMark Funds. The reporting person is employed as a portfolio manager for ArrowMark Colorado and has direct voting and dispositive control over the shares held by the ArrowMark Funds. The reporting person disclaims beneficial ownership of these securities except to the extent of any pecuniary interest therein.
The Series C Preferred Stock automatically converted into shares of Common Stock on a 1:1 basis immediately upon the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
/s/ August J. Moretti, Attorney-in-Fact for Tony Dung Ling Yao
2020-12-17