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*
Quinn William P.

(Last) (First) (Middle)
C/O BOLT BIOTHERAPEUTICS, INC.
900 CHESAPEAKE DRIVE

(Street)
REDWOOD CITY CA 94063

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/04/2021
3. Issuer Name and Ticker or Trading Symbol
Bolt Biotherapeutics, Inc. [ BOLT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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 12,698 D
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
Stock Option (Right to Buy) (1) 07/28/2030 Common Stock 152,301 $2.8 D
Stock Option (Right to Buy) (2) 09/02/2030 Common Stock 35,714 $4.34 D
Stock Option (Right to Buy) (3) 09/02/2030 Common Stock 42,857 $4.34 D
Explanation of Responses:
1. For so long as the Reporting Person continuously provides services to the Issuer, this option will vest with respect to the shares as follows: (a) 28,551 of the shares on the one (1) year anniversary of May 4, 2020 (the "Vesting Commencement Date"); and (b) thereafter, an additional 1/36th of the remaining shares will vest upon the Reporting Person completing each month of continuous service following the first one (1) year anniversary of the Vesting Commencement Date.
2. This shares subject to this option vests over a four-year period with 6,696 shares vesting on June 3, 2021 and the remainder vesting monthly over 39 months from June 3, 2021, subject to the Reporting Person continuing to be a service provider to the Issuer through each such date.
3. This shares subject to this option vests over a four-year period with 3,751 shares vesting on May 15, 2021 and the remainder vesting monthly over 44 months from May 15, 2021, subject to the Reporting Person continuing to be a service provider to the Issuer through each such date.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Brian Woodard, Attorney-in-Fact 02/04/2021
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.