0001209191-18-025825.txt : 20180423 0001209191-18-025825.hdr.sgml : 20180423 20180423161800 ACCESSION NUMBER: 0001209191-18-025825 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180423 FILED AS OF DATE: 20180423 DATE AS OF CHANGE: 20180423 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GRAYZEL DAVID S. CENTRAL INDEX KEY: 0001732786 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38459 FILM NUMBER: 18769086 MAIL ADDRESS: STREET 1: C/O SURFACE ONCOLOGY STREET 2: 50 HAMPSHIRE ST., 8TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02139 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Surface Oncology, Inc. CENTRAL INDEX KEY: 0001718108 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 50 HAMPSHIRE STREET, 8TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 617-714-4096 MAIL ADDRESS: STREET 1: 50 HAMPSHIRE STREET, 8TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02139 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-04-23 0 0001718108 Surface Oncology, Inc. SURF 0001732786 GRAYZEL DAVID S. C/O SURFACE ONCOLOGY, INC. 50 HAMPSHIRE STREET, 8TH FLOOR CAMBRIDGE MA 02139 1 0 0 0 Common Stock 2018-04-23 4 C 0 3181817 A 4545453 I See Footnote Common Stock 2018-04-23 4 P 0 100000 15.00 A 4645453 I See Footnote Series A Preferred Stock 2018-04-23 4 C 0 7000000 D Common Stock 3181817 0 I See Footnote The Series A Preferred Stock automatically converted into the Issuer's common stock on a 2.2-for-1 basis at the closing of the Issuer's initial public offering without payment or further consideration and had no expiration date. The shares are held directly by Atlas Venture Fund IX, L.P. ("Atlas Venture Fund IX"). The general partner of Atlas Venture Fund IX is Atlas Venture Associates IX, L.P. ("AVA IX LP"). Atlas Venture Associates IX, LLC ("AVA IX LLC") is the general partner of AVA IX LP. The Reporting Person owns an interest in AVA IX LP and disclaims beneficial ownership of the securities held by Atlas Venture Fund IX, except to the extent of his pecuniary interest therein, if any. /s/ Frank Castellucci, as Attorney-in-Fact 2018-04-23