0001209191-19-009410.txt : 20190212
0001209191-19-009410.hdr.sgml : 20190212
20190212172544
ACCESSION NUMBER: 0001209191-19-009410
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190212
FILED AS OF DATE: 20190212
DATE AS OF CHANGE: 20190212
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hasnain Faheem
CENTRAL INDEX KEY: 0001352620
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38796
FILM NUMBER: 19592138
MAIL ADDRESS:
STREET 1: 14 CAMBRIDGE CENTER
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Gossamer Bio, Inc.
CENTRAL INDEX KEY: 0001728117
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 475461709
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3013 SCIENCE PARK
CITY: SAN DIEGO
STATE: CA
ZIP: 92121
BUSINESS PHONE: (858) 922-0718
MAIL ADDRESS:
STREET 1: 3013 SCIENCE PARK
CITY: SAN DIEGO
STATE: CA
ZIP: 92121
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-02-12
0
0001728117
Gossamer Bio, Inc.
GOSS
0001352620
Hasnain Faheem
3013 SCIENCE PARK ROAD
SAN DIEGO
CA
92121
1
1
0
0
Executive Chairman
Common Stock
2019-02-12
4
C
0
58599
A
3372109
I
By family trust
Series A Preferred Stock
2019-02-12
4
C
0
185984
D
Common Stock
41329
0
I
By family trust
Series B Preferred Stock
2019-02-12
4
C
0
77719
D
Common Stock
17270
0
I
By family trust
The shares of the Issuer's Series A Preferred Stock and Series B Preferred Stock automatically converted into shares of the Issuer's Common Stock, for no additional consideration, at a ratio of 4.5 to one share, immediately prior to the consummation of the Issuer's initial public offering. The Series A Preferred Stock and Series B Preferred Stock had no expiration date.
Includes 2,595,584 shares subject to forfeiture, which shares will vest in equal monthly installments as set forth in the restricted stock agreements between the Issuer and Reporting Person so that all of the shares will be released from the forfeiture restriction on January 4, 2023, subject to the Reporting Person's continuous service to the Issuer on each such vesting date. The shares are also subject to certain accelerated vesting provisions as set forth in more detail in the employment agreement between the Issuer and the Reporting Person.
/s/ Jeff Boerneke, Attorney-in-Fact
2019-02-12