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