0001209191-20-059088.txt : 20201118 0001209191-20-059088.hdr.sgml : 20201118 20201118162213 ACCESSION NUMBER: 0001209191-20-059088 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201117 FILED AS OF DATE: 20201118 DATE AS OF CHANGE: 20201118 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 5:01 Acquisition LLC CENTRAL INDEX KEY: 0001826636 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39612 FILM NUMBER: 201325369 BUSINESS ADDRESS: STREET 1: 501 SECOND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: 415-993-8570 MAIL ADDRESS: STREET 1: 501 SECOND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 5AM Ventures VI, L.P. CENTRAL INDEX KEY: 0001753037 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39612 FILM NUMBER: 201325370 BUSINESS ADDRESS: STREET 1: 501 SECOND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: 415-993-8570 MAIL ADDRESS: STREET 1: 501 SECOND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 5AM Partners VI, LLC CENTRAL INDEX KEY: 0001829051 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39612 FILM NUMBER: 201325371 BUSINESS ADDRESS: STREET 1: 501 SECOND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: 650 843 5000 MAIL ADDRESS: STREET 1: 501 SECOND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: 5:01 Acquisition Corp. CENTRAL INDEX KEY: 0001823465 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 852790755 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 501 SECOND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: 415-993-8570 MAIL ADDRESS: STREET 1: 501 SECOND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-11-17 0 0001823465 5:01 Acquisition Corp. FVAM 0001826636 5:01 Acquisition LLC 501 SECOND STREET, SUITE 350 SAN FRANCISCO CA 94107 0 0 1 0 0001753037 5AM Ventures VI, L.P. 501 SECOND STREET, SUITE 350 SAN FRANCISCO CA 94107 0 0 1 0 0001829051 5AM Partners VI, LLC 501 SECOND STREET, SUITE 350 SAN FRANCISCO CA 94107 0 0 1 0 Class B Common Stock 2020-11-17 4 J 0 30000 0.00 D Class A Common Stock 30000 2180000 D The shares of Class B common stock are convertible into shares of the issuer's Class A common stock on a one-for-one basis, subject to adjustment pursuant to certain anti-dilution rights, and have no expiration date. In connection with the issuer's appointment of Samantha L. Singer to the issuer's Board of Directors, the Reporting Person transferred 30,000 shares of Class B common stock to Samantha L. Singer. The shares of Class B common stock owned by the Reporting Person includes up to 235,932 shares that are subject to forfeiture in the event the underwriters of the initial public offering of the issuer's securities do not exercise in full their over-allotment option as described in the issuer's registration statement. 5AM Partners VI, LLC is the general partner of 5AM Ventures VI, L.P., the sole member of the Reporting Person, and may be deemed to have sole investment and voting power over the shares held by the Reporting Person. /s/ Nathan Jeffries, Attorney-in-Fact 2020-11-18 /s/ Nathan Jeffries, Attorney-in-Fact 2020-11-18 /s/ Nathan Jeffries, Attorney-in-Fact 2020-11-18