SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
SHV Management Services, LLC

(Last) (First) (Middle)
C/O SANTE VENTURES
300 W 6TH STREET, SUITE 2300

(Street)
AUSTIN TX 78701

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/01/2017
3. Issuer Name and Ticker or Trading Symbol
Molecular Templates, Inc. [ MTEM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 7,897,298 I Held by Sante Health Ventures I, L.P.(1)
Common Stock 864,665 I Held by Sante Health Ventures I Annex Fund, L.P.(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants 08/01/2017 08/01/2024 Common Stock 19,310 $6.8423 I(1) Held by Sante Health Ventures I, L.P.(1)
Warrants 08/01/2017 08/01/2024 Common Stock 4,827 $6.8423 I(1) Held by Sante Health Ventures I Annex Fund, L.P.(1)
1. Name and Address of Reporting Person*
SHV Management Services, LLC

(Last) (First) (Middle)
C/O SANTE VENTURES
300 W 6TH STREET, SUITE 2300

(Street)
AUSTIN TX 78701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Cunningham Joe H

(Last) (First) (Middle)
C/O SANTE VENTURES
300 W 6TH STREET, SUITE 2300

(Street)
AUSTIN 78701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
FRENCH DOUGLAS D

(Last) (First) (Middle)
C/O SANTE VENTURES
300 W 6TH STREET, SUITE 2300

(Street)
AUSTIN TX 78701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SHV Management Services, LP

(Last) (First) (Middle)
300 W 6TH STREET, SUITE 2300

(Street)
AUSTIN TX 78701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SANTE HEALTH VENTURES I LP

(Last) (First) (Middle)
300 W 6TH STREET, SUITE 2300

(Street)
AUSTIN TX 78701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Sante Health Ventures I Annex Fund, LP

(Last) (First) (Middle)
300 W 6TH STREET, SUITE 2300

(Street)
AUSTIN TX 78701

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The securities held by Sante Health Ventures I, L.P. and Sante Health Ventures I Annex Fund, L.P. may be deemed to be beneficially owned by Joe Cunningham, M.D. and Douglas D. French, who are managing directors (the "SHV Directors") of SHV Management Services, LLC ("SHV Management"). SHV Management is the general partner of SHV Management Services, LP, which is the general partner of Sante Health Ventures I, L.P., and SHV Annex Services, LP, which is the general partner of Sante Health Ventures I Annex Fund, L.P. Each of the SHV Directors, SHV Management, SHV Management Services, LP and SHV Annex Services, LP disclaims beneficial ownership of the reported securities except to the extent of his or its pecuniary interest therein.
Remarks:
SHV MANAGEMENT SERVICES, LLC, By: Kevin Lalande, Its Managing Member, By: /s/ Jason S. Kim, Attorney in fact 08/11/2017
SHV MANAGEMENT SERVICES, L.P., By: SHV Management Services, LLC, Its general partner, By: Kevin Lalande, Its Managing Member, By: /s/ Jason S. Kim, Attorney in fact 08/11/2017
SANTE HEALTH VENTURES I, L.P., By: SHV Management Services, L.P., Its general partner, By: SHV Management Services, LLC, Its general partner, By: Kevin Lalande, Its Managing Member, By: /s/ Jason S. Kim, Attorney in fact 08/11/2017
SANTE HEALTH VENTURES I ANNEX FUND, L.P., By: SHV Annex Services, LP, Its general partner, By: SHV Management Services, LLC, Its general partner, By: Kevin Lalande, Its Managing Member, By: /s/ Jason S. Kim, Attorney in fact 08/11/2017
JOE CUNNINGHAM, MD, By: /s/ Jason S. Kim, Attorney-in-Fact 08/11/2017
DOUGLAS D. FRENCH, By: /s/ Jason S. Kim, Attorney in fact 08/11/2017
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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