0000899243-21-019683.txt : 20210517 0000899243-21-019683.hdr.sgml : 20210517 20210517210415 ACCESSION NUMBER: 0000899243-21-019683 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210513 FILED AS OF DATE: 20210517 DATE AS OF CHANGE: 20210517 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Brous Tyler CENTRAL INDEX KEY: 0001827387 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39593 FILM NUMBER: 21933471 MAIL ADDRESS: STREET 1: 1018 W 11TH ST., SUITE 100 CITY: AUSTIN STATE: TX ZIP: 78703 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Shattuck Labs, Inc. CENTRAL INDEX KEY: 0001680367 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 812575858 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1018 W. 11TH STREET CITY: AUSTIN STATE: TX ZIP: 78703 BUSINESS PHONE: 919-864-2700 MAIL ADDRESS: STREET 1: 1018 W. 11TH STREET CITY: AUSTIN STATE: TX ZIP: 78703 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-05-13 0 0001680367 Shattuck Labs, Inc. STTK 0001827387 Brous Tyler C/O SHATTUCK LABS, INC. 500 W. 5TH STREET, SUITE 1200 AUSTIN TX 78701 1 0 0 0 Common Stock 2021-05-13 4 J 0 629432 0.00 D 52745 I See Footnote Common Stock 2021-05-13 4 J 0 16440 0.00 D 0 I See Footnote Common Stock 2021-05-13 4 J 0 27235 0.00 D 0 I See Footnote Common Stock 2021-05-13 4 J 0 137641 0.00 A 168466 D Common Stock 2021-05-13 4 J 0 6347 0.00 A 174813 D Common Stock 2021-05-13 4 J 0 6593 0.00 A 181406 D Common Stock 87132 I See Footnote Represents a pro rata distribution, and not a purchase or sale, without additional consideration by Lennox Dallas Partners, LP ("Lennox Partners") to its limited partners. These shares are held directly by Lennox Partners. The Reporting Person is the vice president of RS Holdings, Inc., the general partner of Lennox Partners. The Reporting Person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except the extent of his pecuniary interest therein. Represents a pro rata distribution, and not a purchase or sale, without additional consideration by Lennox Dallas Holdings, LLC - Series 3 ("Lennox Series 3") to its limited partners. These shares are held directly by Lennox Series 3. The Reporting Person is the Manager of Lennox Series 3. The Reporting Person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except the extent of his pecuniary interest therein. Represents a pro rata distribution, and not a purchase or sale, without additional consideration by Lennox Dallas Holdings, LLC - Series 9 ("Lennox Series 9") to its limited partners. These shares are held directly by Lennox Series 9. The Reporting Person is the Manager of Lennox Series 9. The Reporting Person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except the extent of his pecuniary interest therein. These shares are held directly by Lennox Dallas Holdings, LLC - Series 10. The Reporting Person is the Manager of Lennox Dallas Holdings, LLC - Series 10. The Reporting Person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except the extent of his pecuniary interest therein. /s/ Erin Ator Thomson, Attorney-in-Fact for Tyler Brous 2021-05-17