0001209191-23-055884.txt : 20231117 0001209191-23-055884.hdr.sgml : 20231117 20231117182611 ACCESSION NUMBER: 0001209191-23-055884 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231115 FILED AS OF DATE: 20231117 DATE AS OF CHANGE: 20231117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Blackman Samuel C. CENTRAL INDEX KEY: 0001863676 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40431 FILM NUMBER: 231420322 MAIL ADDRESS: STREET 1: 395 OYSTER POINT BLVD. STREET 2: SUITE 217 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Day One Biopharmaceuticals, Inc. CENTRAL INDEX KEY: 0001845337 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 832415215 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2000 SIERRA POINT PARKWAY, SUITE 501 CITY: BRISBANE STATE: CA ZIP: 94005 BUSINESS PHONE: 650 484-0899 MAIL ADDRESS: STREET 1: 2000 SIERRA POINT PARKWAY, SUITE 501 CITY: BRISBANE STATE: CA ZIP: 94005 FORMER COMPANY: FORMER CONFORMED NAME: Day One Biopharmaceuticals Holding Co LLC DATE OF NAME CHANGE: 20210209 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-11-15 0 0001845337 Day One Biopharmaceuticals, Inc. DAWN 0001863676 Blackman Samuel C. 2000 SIERRA POINT PARKWAY, SUITE 501 BRISBANE CA 94005 0 1 0 0 Head of Research and Developme 0 Common Stock 2023-11-15 4 M 0 1187 A 1237506 D Common Stock 2023-11-15 4 M 0 1437 A 1238943 D Common Stock 2023-11-16 4 S 0 709 11.69 D 1238234 D Common Stock 1000000 I See Footnote Restricted Stock Units 2023-11-15 4 M 0 1187 0.00 D Common Stock 1187 9504 D Restricted Stock Units 2023-11-15 4 M 0 1437 0.00 D Common Stock 1437 17252 D Each Restricted Stock Unit ("RSU") represents a contingent right to receive one share of the Issuer's Common Stock upon settlement for no consideration. The sale of shares is for the sole purpose of covering the Reporting Person's tax liability with respect to the settlement of RSUs. The Reporting Person is the sole manager, and has shared voting and dispositive power with his wife as members. The Reporting Person continues to report beneficial ownership of all of the Issuer's Common Stock held by the 2021 Blackman Family LLC but disclaims beneficial ownership except to the extent of his and his wife's pecuniary interest therein. The RSUs will vest as to 1/16th of the total award in quarterly installments on February 15, May 15, August 15 and November 15, subject to the Reporting Person's provision of service to the Issuer on each vesting date. /s/ Charles N. York II, Attorney-in-Fact 2023-11-17