0001415889-24-019309.txt : 20240705 0001415889-24-019309.hdr.sgml : 20240705 20240705181111 ACCESSION NUMBER: 0001415889-24-019309 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240702 FILED AS OF DATE: 20240705 DATE AS OF CHANGE: 20240705 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bender Jeremy CENTRAL INDEX KEY: 0001863107 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40431 FILM NUMBER: 241103179 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] ORGANIZATION NAME: 03 Life Sciences 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 form4-07052024_100707.xml X0508 4 2024-07-02 0001845337 Day One Biopharmaceuticals, Inc. DAWN 0001863107 Bender Jeremy 2000 SIERRA POINT PARKWAY, SUITE 501 BRISBANE CA 94005 true true false false CHIEF EXECUTIVE OFFICER 0 Common Stock 2024-07-02 4 G 0 59075 0 D 162762 I See Footnote Common Stock 2024-07-02 4 G 0 59075 0 A 624189 I By Bender Revocable Trust Common Stock 2024-07-02 4 G 0 29606 0 D 222030 I See Footnote Common Stock 2024-07-02 4 G 0 29606 0 A 653795 I By Bender Revocable Trust Common Stock 2024-07-02 4 G 0 80619 0 D 219406 I See Footnote Common Stock 2024-07-02 4 G 0 80619 0 A 734414 I By Bender Revocable Trust Common Stock 2024-07-02 4 G 0 72612 0 D 197614 I See Footnote Common Stock 2024-07-02 4 G 0 72612 0 A 807026 I By Bender Revocable Trust Common Stock 89614 D Represents an annuity payment made by The Jeremy Bender 2022 Grantor Retained Annuity Trust under Irrevocable Trust Agreement dated March 29, 2022 ("Jeremy Bender 2022 GRAT"), which was transferred by the Reporting Person as a bona fide gift for no consideration to the Bender Revocable Trust dated January 18, 2017, as amended, Jeremy Bender and Melissa C. Bender, Trustees ("Bender Revocable Trust dated January 18, 2017"). Represents shares held by the Jeremy Bender 2022 GRAT of which the Reporting Person is trustee. Includes 565,114 shares of the Issuer's Common Stock that the Reporting Person retitled on July 2, 2024. Represents shares held by the Bender Revocable Trust dated January 18, 2017. Represents an annuity payment made by The Melissa Bender 2022 Grantor Retained Annuity Trust under Irrevocable Trust Agreement dated March 29, 2022 ("Melissa Bender 2022 GRAT"), which was transferred by the Reporting Person as a bona fide gift for no consideration to the Bender Revocable Trust dated January 18, 2017. Represents shares held by the Melissa Bender 2022 GRAT of which the Reporting Person's spouse is trustee. Represents an annuity payment made by The Jeremy Bender 2023 Grantor Retained Annuity Trust dated June 27, 2023 ("Jeremy Bender 2023 GRAT"), which was transferred by the Reporting Person as a bona fide gift for no consideration to the Bender Revocable Trust dated January 18, 2017. Represents shares held by the Jeremy Bender 2023 GRAT. Represents an annuity payment made by The Melissa Bender 2023 Grantor Retained Annuity Trust, dated June 27, 2023 ("Melissa Bender 2023 GRAT"), which was transferred by the Reporting Person as a bona fide gift for no consideration to the Bender Revocable Trust dated January 18, 2017. Represents shares held by the Melissa Bender 2023 GRAT. /s/ Charles N. York II, Attorney-in-Fact 2024-07-05