0000899243-21-027012.txt : 20210701 0000899243-21-027012.hdr.sgml : 20210701 20210701190042 ACCESSION NUMBER: 0000899243-21-027012 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210113 FILED AS OF DATE: 20210701 DATE AS OF CHANGE: 20210701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KARSEN PERRY A CENTRAL INDEX KEY: 0001260573 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40532 FILM NUMBER: 211067524 MAIL ADDRESS: STREET 1: C/O CELGENE CORPORATION STREET 2: 86 MORRIS AVENUE CITY: SUMMIT STATE: NJ ZIP: 07901 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Graphite Bio, Inc. CENTRAL INDEX KEY: 0001815776 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 844867570 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 279 EAST GRAND AVENUE, SUITE 430 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 BUSINESS PHONE: (650) 484-0886 MAIL ADDRESS: STREET 1: 279 EAST GRAND AVENUE, SUITE 430 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 FORMER COMPANY: FORMER CONFORMED NAME: Integral Medicines, Inc. DATE OF NAME CHANGE: 20200622 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-01-13 0 0001815776 Graphite Bio, Inc. GRPH 0001260573 KARSEN PERRY A C/O GRAPHITE BIO, INC. 279 EAST GRAND AVENUE, SUITE 430 SOUTH SAN FRANCISCO CA 94080 1 0 0 0 Common Stock 2021-06-29 4 C 0 8126 A 164034 D Stock Option (right to buy) 0.30 2021-01-13 4 A 0 74794 0.00 A 2031-01-12 Common Stock 74794 74794 D Series B Preferred Stock 2021-03-11 4 A 0 19763 5.06 A Common Stock 8126 19763 D Stock Option (right to buy) 6.11 2021-03-17 4 A 0 18698 0.00 A 2031-03-16 Common Stock 18698 18698 D Series B Preferred Stock 2021-06-29 4 C 0 19763 0.00 D Common Stock 8126 0 D These shares of Series B Preferred Stock were convertible at any time at the holder's election and automatically converted on a 2.432-for-one basis into shares of the Issuer's common stock immediately upon the closing of the Issuer's initial public offering ("IPO") without payment of additional consideration. The Series B Preferred Stock had no expiration date. On June 21, 2021, the Issuer completed a one-for-2.432 reverse stock split of the Issuer's Common Stock ("Reverse Stock Split"). This amount has been adjusted to give effect to this Reverse Stock Split. This transaction occurred prior to the IPO and is being reported on Form 4 solely for purposes of compliance with Rule 16a-2(a) under the Securities Exchange Act of 1934, as amended. The securities covered by such transaction were previously included on the Reporting Person's Form 3. 1/48th of the shares subject to such option vest and become exercisable in substantially equal monthly installments on each monthly anniversary of June 5, 2020, subject to the Reporting Person's continuous service to the Issuer on each such date. The option provides for an early exercise provision of unvested shares, subject to the Issuer's right to repurchase. 1/48th of the shares subject to such option vest and become exercisable in substantially equal monthly installments on each monthly anniversary of March 17, 2021, subject to the Reporting Person's continuous service to the Issuer on each such date. /s/ Franco Valle, attorney-in-fact 2021-07-01