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