0001209191-21-008750.txt : 20210209 0001209191-21-008750.hdr.sgml : 20210209 20210209152944 ACCESSION NUMBER: 0001209191-21-008750 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210209 FILED AS OF DATE: 20210209 DATE AS OF CHANGE: 20210209 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HEALY JAMES CENTRAL INDEX KEY: 0001245624 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39988 FILM NUMBER: 21605998 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD, 4-250 CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Bolt Biotherapeutics, Inc. CENTRAL INDEX KEY: 0001641281 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 472804636 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 900 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-665-9295 MAIL ADDRESS: STREET 1: 900 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: Bolt Therapeutics, Inc. DATE OF NAME CHANGE: 20150504 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-02-09 0 0001641281 Bolt Biotherapeutics, Inc. BOLT 0001245624 HEALY JAMES C/O BOLT BIOTHERAPEUTICS, INC. 900 CHESAPEAKE DRIVE REDWOOD CITY CA 94063 1 0 0 0 Common Stock 2021-02-09 4 C 0 1104209 A 1104209 I By Sofinnova Venture Partners X, L.P. Common Stock 2021-02-09 4 C 0 1200228 A 2304437 I By Sofinnova Venture Partners X, L.P. Common Stock 2021-02-09 4 P 0 450000 20.00 A 2754437 I By Sofinnova Venture Partners X, L.P. Series C-1 Preferred Stock 2021-02-09 4 C 0 1104209 0.00 D Common Stock 1104209 0 I By Sofinnova Venture Partners X, L.P. Series C-2 Preferred Stock 2021-02-09 4 C 0 1200228 0.00 D Common Stock 1200228 0 I By Sofinnova Venture Partners X, L.P. The Series C-1 Preferred Stock automatically converted into shares of Common Stock of the Issuer on a 1:1 basis immediately upon closing of the Issuer's initial public offering (the "IPO") and had no expiration date. The securities reported herein are held of record by Sofinnova Venture Partners X, L.P. ("SVP X"). Sofinnova Management X, L.L.C. ("SM X") is the general partner of SVP X. The Reporting Person is one of three managing members of SM X and may be deemed to have shared voting and dispositive power over the shares held by SVP X. The Reporting Person disclaims beneficial ownership over such shares except to the extent of his pecuniary interest therein. The Series C-2 Preferred Stock automatically converted into shares of Common Stock of the Issuer on a 1:1 basis immediately upon closing of the Issuer's IPO and had no expiration date. /s/ Brian Woodard, Attorney-in-Fact 2021-02-09