0001209191-21-037022.txt : 20210601
0001209191-21-037022.hdr.sgml : 20210601
20210601215009
ACCESSION NUMBER: 0001209191-21-037022
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210601
FILED AS OF DATE: 20210601
DATE AS OF CHANGE: 20210601
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Spaventa Andrew
CENTRAL INDEX KEY: 0001859701
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40443
FILM NUMBER: 21987554
MAIL ADDRESS:
STREET 1: 10931 N. TORREY PINES ROAD, SUITE 100
CITY: LA JOLLA
STATE: CA
ZIP: 92037
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Singular Genomics Systems, Inc.
CENTRAL INDEX KEY: 0001850906
STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826]
IRS NUMBER: 812948451
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 10931 N. TORREY PINES ROAD, SUITE #100
CITY: LA JOLLA
STATE: CA
ZIP: 92037
BUSINESS PHONE: (858) 333-7830
MAIL ADDRESS:
STREET 1: 10931 N. TORREY PINES ROAD, SUITE #100
CITY: LA JOLLA
STATE: CA
ZIP: 92037
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-06-01
0
0001850906
Singular Genomics Systems, Inc.
OMIC
0001859701
Spaventa Andrew
10931 N. TORREY PINES ROAD
SUITE#100
LA JOLLA
CA
92037
1
1
0
0
Chief Executive Officer
Common Stock
2021-06-01
4
C
0
715884
A
715884
I
By Axon Holdings, LLC
Common Stock
2021-06-01
4
C
0
173144
17.60
A
889028
I
By Axon Holdings, LLC
Common Stock
4613571
I
By The Andrew K. Spaventa Living Trust dated April 9, 2014
Series Seed Preferred Stock
2021-06-01
4
C
0
362266
D
Common Stock
362266
0
I
By Axon Holdings, LLC
Series A Preferred Stock
2021-06-01
4
C
0
201155
D
Common Stock
201155
0
I
By Axon Holdings, LLC
Series B Preferred Stock
2021-06-01
4
C
0
152463
D
Common Stock
152463
0
I
By Axon Holdings, LLC
Convertible Promissory Note
2021-06-01
4
C
0
173144
D
Common Stock
173144
0
I
By Axon Holdings, LLC
Immediately prior to the closing of the Issuer's initial public offering ("IPO"), each share of the Series Seed Preferred Stock, Series A Preferred Stock, and Series B Preferred Stock (collectively, the "Preferred Stock") automatically converted into shares of the Issuer's common stock, par value $0.0001 per share, on a one-for-one basis. The shares of Preferred Stock had no expiration date.
The shares are held directly by Axon Holdings, LLC. The managing member of Axon Holdings, LLC is Axon Managers, LLC. The Reporting Person is a managing member of Axon Managers, LLC. and may be deemed to have shared voting and investment power over the shares held by Axon Holdings, LLC. The Reporting Person disclaims beneficial ownership of the shares except to the extent of his pecuniary interest therein. The holdings of Axon Holdings, LLC depicted above reflect applicable transfers and related transactions prior to the IPO from Axon Ventures X, LLC.
Immediately prior to the closing of the Issuer's IPO, the Convertible Note automatically converted into shares of the Issuer's common stock at a conversion price of $17.60 per share.
The maturity date of the Convertible Note is the earliest to occur of (1) February 25, 2023 and (2) an Event of Default as defined in the related Note Purchase Agreement.
/s/ Dalen Meeter, Attorney-in-Fact
2021-06-01