0000950170-24-107525.txt : 20240917
0000950170-24-107525.hdr.sgml : 20240917
20240917200529
ACCESSION NUMBER: 0000950170-24-107525
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240916
FILED AS OF DATE: 20240917
DATE AS OF CHANGE: 20240917
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Aynechi Tiba
CENTRAL INDEX KEY: 0001669220
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-42272
FILM NUMBER: 241305888
MAIL ADDRESS:
STREET 1: C/O NVP ASSOCIATES, LLC
STREET 2: 1300 EL CAMINO REAL, SUITE 200
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MBX Biosciences, Inc.
CENTRAL INDEX KEY: 0001776111
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
ORGANIZATION NAME: 03 Life Sciences
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 12406 HORESHAM STREET
CITY: CARMEL
STATE: IN
ZIP: 46032
BUSINESS PHONE: 3179893100
MAIL ADDRESS:
STREET 1: 12406 HORESHAM STREET
CITY: CARMEL
STATE: IN
ZIP: 46032
4
1
ownership.xml
4
X0508
4
2024-09-16
0001776111
MBX Biosciences, Inc.
MBX
0001669220
Aynechi Tiba
C/O MBX BIOSCIENCES, INC.
11711 N. MERIDIAN STREET, SUITE 300
CARMEL
IN
46032
true
false
false
false
false
Common Stock
2024-09-16
4
C
false
1386335
A
1386335
I
By Norwest Venture Partners XVI, LP
Common Stock
2024-09-16
4
P
false
750000
16
A
2136335
I
By Norwest Venture Partners XVI, LP
Series B Convertible Preferred Stock
2024-09-16
4
C
false
16666666
D
Common Stock
1386335
0
I
By Norwest Venture Partners XVI, LP
Each share of Series B Convertible Preferred Stock (the "Preferred Stock") was convertible into Common Stock on a one-for-12.0221 basis at any time at the option of the holder, and automatically converted into the number of shares shown in Column 7 immediately prior to the closing of the Issuer's initial public offering on September 16, 2024. The Preferred Stock had no expiration date.
The securities are directly held by Norwest Venture Partners XVI, LP ("NVP XVI"). Genesis VC Partners XVI, LLC ("Genesis XVI") is the general partner of NVP XVI and NVP Associates, LLC ("NVP Associates") is the managing member of Genesis XVI. The Reporting Person, as an officer of NVP Associates and director of the Issuer, may be deemed to share voting and dispositive power over the shares held by NVP XVI and disclaims beneficial ownership of such securities except to the extent of her pecuniary interest therein.
Reflects shares purchased in the Issuer's initial public offering.
/s/ Richard Bartram, attorney-in-fact
2024-09-17