SC 13G

NAMES OF REPORTING PERSONS

Ted Davis

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)

(A) ☐ (B) ☐

SEC USE ONLY

CITIZENSHIP OR PLACE OF ORGANIZATION

United States

0001193125-22-041911.txt : 20220214 0001193125-22-041911.hdr.sgml : 20220214 20220214163317 ACCESSION NUMBER: 0001193125-22-041911 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 2 FILED AS OF DATE: 20220214 DATE AS OF CHANGE: 20220214 GROUP MEMBERS: IRENE DAVIS SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: Alpha Teknova, Inc. CENTRAL INDEX KEY: 0001850902 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 943368109 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-93539 FILM NUMBER: 22633088 BUSINESS ADDRESS: STREET 1: 2290 BERT DRIVE CITY: HOLLISTER STATE: CA ZIP: 95023 BUSINESS PHONE: 8316371100 MAIL ADDRESS: STREET 1: 2290 BERT DRIVE CITY: HOLLISTER STATE: CA ZIP: 95023 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Davis Ted CENTRAL INDEX KEY: 0001862114 FILING VALUES: FORM TYPE: SC 13G MAIL ADDRESS: STREET 1: 2290 BERT DRIVE CITY: HOLLISTER STATE: CA ZIP: 95023 SC 13G 1 d324174dsc13g.htm SC 13G SC 13G

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

SCHEDULE 13G

Under the Securities Exchange Act of 1934

(Amendment No. )*

ALPHA TEKNOVA, INC.

(Name of Issuer)

Common Stock, $0.00001 par value

(Title of Class of Securities)

02080L 102

(CUSIP Number)

December 31, 2021

(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

☐ Rule 13d-1(b)

☐ Rule 13d-1(c)

☒ Rule 13d-1(d)

*	The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

13G


CUSIP No. 02080L 102		Page 2 of 8 Pages

⁽¹⁾

Includes: (a) 1,886,419 shares of common stock of the Issuer owned directly by Mr. Davis and (b) 1,687,140 shares of common stock of the Issuer owned directly by Irene Davis, Mr. Davis’ spouse. Mr. Davis and Mrs. Davis are husband and wife and each of them may be deemed to have shared voting power and dispositive power over the shares of common stock of the Issuer held by each other. Mr. and Mrs. Davis are also both directors of the Issuer.

⁽²⁾	Percentage based on 28,011,917 shares of the Issuer’s Common Stock outstanding as of November 9, 2021, as reported in the Issuer’s Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on November 12, 2021.

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CUSIP No. 02080L 102		Page 3 of 8 Pages

⁽¹⁾

Includes: (i) 1,687,140 shares of common stock of the Issuer owned directly by Mrs. Davis and (ii) 1,886,419 shares of common stock of the Issuer owned directly by Ted Davis, Mrs. Davis’ spouse. Mr. Davis and Mrs. Davis are husband and wife and each of them may be deemed to have shared voting power and dispositive power over the shares of common stock of the Issuer held by each other. Mr. and Mrs. Davis are also both directors of the Issuer.

⁽²⁾	Percentage based on 28,011,917 shares of the Issuer’s Common Stock outstanding as of November 9, 2021, as reported in the Issuer’s Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on November 12, 2021.

13G


CUSIP No. 02080L 102		Page 4 of 8 Pages

Item 1.

(a)

Name of Issuer

Alpha Teknova, Inc.

(b)

Address of Issuer’s Principal Executive Offices

2290 Bert Dr.

Hollister, California 95023

Item 2.

(a)

Name of Persons Filing

(i) Ted Davis

(ii) Irene Davis (together, the “Reporting Persons”)

(b)

Address of Principal Business office or, if None, Residence

2290 Bert Dr.

Hollister, California 95023

(c)

Citizenship

The Reporting Persons are citizens of the United States.

(d)

Title of Class of Securities

Common Stock, $0.00001 par value

(e)

CUSIP Number

02080L 102

Item 3.

If this statement is filed pursuant to §§ 240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:

(a)

☐ Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o);

(b)

☐ Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c);

(c)

☐ Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c);

(d)

☐ Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8);

(e)

☐ An investment adviser in accordance with § 240.13d-1(b)(1)(ii)(E);

(f)

☐ An employee benefit plan or endowment fund in accordance with § 240.13d-1(b)(1)(ii)(F);

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CUSIP No. 02080L 102		Page 5 of 8 Pages

(g)

☐ A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G);

(h)

☐ A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);

(i)

☐ A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company

Act of 1940 (15 U.S.C. 80a-3);

(j)

☐ A non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J);

(k)

☐ Group, in accordance with § 240.13d-1(b)(1)(ii)(K).

If filing as a non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J), please specify the type of institution: .

Item 4.

Ownership.

(i) Ted Davis

(a)

Amount beneficially owned: 3,573,559

(b)

Percent of class:

12.8%*

(c)

Number of shares as to which the person has:

(i)

Sole power to vote or to direct the vote:

(ii)

Shared power to vote or to direct the vote:

3,573,559 ⁽¹⁾

(iii)

Sole power to dispose or to direct the disposition of:

(iv)

Shared power to dispose or to direct the disposition of:

3,573,559 ⁽¹⁾

⁽¹⁾

Includes: (i) 1,886,419 shares of common stock of the Issuer owned directly by Mr. Davis and (ii) 1,687,140 shares of common stock of the Issuer owned directly by Irene Davis, Mr. Davis’ spouse. Mr. Davis and Mrs. Davis are husband and wife and each of them may be deemed to have shared voting power and dispositive power over the shares of common stock of the Issuer held by each other. Mr. and Mrs. Davis are also both directors of the Issuer.

*	Percentage based on 28,011,917 shares of the Issuer’s Common Stock outstanding as of November 9, 2021, as reported in the Issuer’s Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on November 12, 2021.

(i) Irene Davis

(a)

Amount beneficially owned: 3,573,559

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CUSIP No. 02080L 102		Page 6 of 8 Pages

(b)

Percent of class:

12.8%*

(c)

Number of shares as to which the person has:

(i)

Sole power to vote or to direct the vote:

(ii)

Shared power to vote or to direct the vote:

3,573,559 ⁽¹⁾

(iii)

Sole power to dispose or to direct the disposition of:

(iv)

Shared power to dispose or to direct the disposition of:

3,573,559 ⁽¹⁾

⁽¹⁾

*	Percentage based on 28,011,917 shares of the Issuer’s Common Stock outstanding as of November 9, 2021, as reported in the Issuer’s Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on November 12, 2021.

Item 5.

Ownership of Five Percent or Less of a Class.

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than 5 percent of the class of securities, check the following ☐

Item 6.

Ownership of More than Five Percent on Behalf of Another Person.

Not applicable.

Item 7.

Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person.

Not applicable.

Item 8.

Identification and Classification of Members of the Group.

Not applicable.

Item 9.

Notice of Dissolution of Group.

Not applicable.

Item 10.

Certifications.

Not applicable.

13G


CUSIP No. 02080L 102		Page 7 of 8 Pages

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

EXHIBIT INDEX


Exhibit Number		Description

99.1		Power of Attorney (incorporated by reference to Exhibit 24.1 to the Reporting Persons’ Initial Statement of Beneficial Ownership of Securities on Form 3, filed with the Securities and Exchange Commission on June 24, 2021).

99.2		Power of Attorney (incorporated by reference to Exhibit 24.2 to the Reporting Persons’ Initial Statement of Beneficial Ownership of Securities on Form 3, filed with the Securities and Exchange Commission on June 24, 2021).

99.3*		Joint Filing Agreement.

*	Filed herewith.

EX-99.3 2 d324174dex993.htm EX-99.3 EX-99.3

Exhibit 99.3

EXHIBIT 99.3 – JOINT FILING AGREEMENT

In accordance with Rule 13d-1(k) under the Securities Exchange Act of 1934, as amended, the undersigned agree to the joint filing on behalf of each of them of a Statement on Schedule 13G (including any and all amendments thereto) with respect to the Common Stock of Alpha Teknova, Inc. and further agree that this Joint Filing Agreement shall be included as an Exhibit to such joint filings.

The undersigned further agree that each party hereto is responsible for the timely filing of such Statement on Schedule 13G and any amendments thereto, and for the accuracy and completeness of the information concerning such party contained therein; provided, however, that no party is responsible for the accuracy or completeness of the information concerning any other party, unless such party knows or has reason to believe that such information is inaccurate.

This Joint Filing Agreement may be signed in counterparts with the same effect as if the signature on each counterpart were upon the same instrument.

IN WITNESS WHEREOF, the undersigned have executed this Agreement as of February 14, 2022.