0001628280-23-003923.txt : 20230216 0001628280-23-003923.hdr.sgml : 20230216 20230216165422 ACCESSION NUMBER: 0001628280-23-003923 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230214 FILED AS OF DATE: 20230216 DATE AS OF CHANGE: 20230216 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AKKARAJU SRINIVAS CENTRAL INDEX KEY: 0001253170 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41614 FILM NUMBER: 23639184 MAIL ADDRESS: STREET 1: 565 EVERETT AVENUE CITY: PALO ALTO STATE: CA ZIP: 94301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Samsara BioCapital, L.P. CENTRAL INDEX KEY: 0001699737 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41614 FILM NUMBER: 23639183 BUSINESS ADDRESS: STREET 1: 628 MIDDLEFIELD ROAD CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: (650) 285-4270 MAIL ADDRESS: STREET 1: 628 MIDDLEFIELD ROAD CITY: PALO ALTO STATE: CA ZIP: 94301 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Mineralys Therapeutics, Inc. CENTRAL INDEX KEY: 0001933414 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 150 N. RADNOR CHESTER ROAD STREET 2: SUITE F200 CITY: RADNOR STATE: PA ZIP: 19087 BUSINESS PHONE: (888) 378-6240 MAIL ADDRESS: STREET 1: 150 N. RADNOR CHESTER ROAD STREET 2: SUITE F200 CITY: RADNOR STATE: PA ZIP: 19087 4 1 wf-form4_167658444611991.xml FORM 4 X0306 4 2023-02-14 0 0001933414 Mineralys Therapeutics, Inc. MLYS 0001253170 AKKARAJU SRINIVAS 628 MIDDLEFIELD ROAD PALO ALTO CA 94301 1 0 1 0 0001699737 Samsara BioCapital, L.P. 628 MIDDLEFIELD ROAD PALO ALTO CA 94301 0 0 1 0 Common Stock 2023-02-14 4 C 0 3581861 A 3581861 I See footnote Common Stock 2023-02-14 4 P 0 937500 16 A 4519361 I See footnote Series A Preferred Stock 2023-02-14 4 C 0 2135504 0 D Common Stock 2135504.0 0 I See footnote Series B Preferred Stock 2023-02-14 4 C 0 1446357 0 D Common Stock 1446357.0 0 I See footnote Each share of preferred stock of the Issuer automatically converted into shares of common stock on a 10.798-for-one basis (which reflects the reverse stock split effected by the Issuer on February 1, 2023) upon closing of the Issuer's initial public offering. Represents securities held directly by Samsara BioCapital, L.P. Samsara BioCapital GP, LLC ("Samsara LLC") is the general partner of Samsara BioCapital, L.P. ("Samsara LP") and may be deemed to beneficially own the shares held by Samsara LP. Dr. Akkaraju has voting and investment power over the shares held by Samsara LP and, accordingly, may be deemed to beneficially own the shares held by Samsara LP. Each of Samsara LLC and Dr. Akkaraju disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein. /s/ Srinivas Akkaraju 2023-02-16 Samsara BioCapital, L.P. By: Samsara BioCapital GP, LLC, its General Partner, By /s/ Srinivas Akkaraju, Managing Member 2023-02-16