0001209191-21-049368.txt : 20210803
0001209191-21-049368.hdr.sgml : 20210803
20210803165146
ACCESSION NUMBER: 0001209191-21-049368
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210803
FILED AS OF DATE: 20210803
DATE AS OF CHANGE: 20210803
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FAIRBAIRN EMILY
CENTRAL INDEX KEY: 0001682638
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39692
FILM NUMBER: 211140622
MAIL ADDRESS:
STREET 1: 10 ORINDA VIEW ROAD
CITY: ORINDA
STATE: CA
ZIP: 94563
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Transcend Partners Opportunity Fund LLC
CENTRAL INDEX KEY: 0001832019
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39692
FILM NUMBER: 211140621
BUSINESS ADDRESS:
STREET 1: 10 ORINDA VIEW ROAD
CITY: ORINDA
STATE: CA
ZIP: 94563
BUSINESS PHONE: (646) 600-6438
MAIL ADDRESS:
STREET 1: 10 ORINDA VIEW ROAD
CITY: ORINDA
STATE: CA
ZIP: 94563
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: IN8BIO, INC.
CENTRAL INDEX KEY: 0001740279
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 825462585
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 79 MADISON AVENUE, 2ND FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10016
BUSINESS PHONE: (646) 600-6438
MAIL ADDRESS:
STREET 1: 79 MADISON AVENUE, 2ND FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10016
FORMER COMPANY:
FORMER CONFORMED NAME: Incysus Therapeutics, Inc.
DATE OF NAME CHANGE: 20180510
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-08-03
0
0001740279
IN8BIO, INC.
INAB
0001682638
FAIRBAIRN EMILY
10 ORINDA VIEW ROAD
ORINDA
CA
94563
1
0
1
0
0001832019
Transcend Partners Opportunity Fund LLC
10 ORINDA VIEW ROAD
ORINDA
CA
94563
0
0
1
0
Common Stock
2021-08-03
4
C
0
83124
A
91336
I
See footnote
Common Stock
2021-08-03
4
C
0
27706
A
27706
I
See footnote
Common Stock
2021-08-03
4
C
0
3222485
A
3222485
I
See footnote
Common Stock
2021-08-03
4
P
0
100000
10.00
A
3322485
I
See footnote
Series A Preferred Stock
2021-08-03
4
C
0
75588
0.00
D
Common Stock
83124
0
I
See footnote
Series A Preferred Stock
2021-08-03
4
C
0
25195
0.00
D
Common Stock
27706
0
I
See footnote
Series A Preferred Stock
2021-08-03
4
C
0
2930332
0.00
D
Common Stock
3222485
0
I
See footnote
Each share of Series A Preferred Stock was convertible at any time at the option of the holder, without payment of additional consideration, into
Common Stock, on a 1.0997 for 1 basis, had no expiration date and automatically converted into shares of Common Stock upon the
closing of the Issuer's initial public offering.
The securities are held by Valley High Limited Partnership ("Valley High"). Emily Fairbairn is the sole managing partner of Valley High and has
voting and investment power over the shares held by Valley High.
The securities are held by Emily T. Fairbairn Roth IRA ("Roth IRA"). Emily Fairbairn exercises control over the Roth IRA, and as such, has voting
and investment power over the shares held by the Roth IRA.
The securities are held by Transcend Partners Opportunity Fund LLC ("Transcend"). Emily Fairbairn is the sole managing member of Transcend
and has voting and investment power over the shares held by Transcend.
/s/ Jason Minio, Attorney-in-Fact
2021-08-03
/s/ Jason Minio, Attorney-in-Fact
2021-08-03