0001728117-21-000006.txt : 20210212 0001728117-21-000006.hdr.sgml : 20210212 20210212162506 ACCESSION NUMBER: 0001728117-21-000006 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20210212 DATE AS OF CHANGE: 20210212 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: Gujrathi Sheila CENTRAL INDEX KEY: 0001575202 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-92190 FILM NUMBER: 21627964 MAIL ADDRESS: STREET 1: 10835 ROAD TO THE CURE STREET 2: SUITE 205 CITY: SAN DIEGO STATE: CA ZIP: 92121 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Gossamer Bio, Inc. CENTRAL INDEX KEY: 0001728117 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 475461709 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 3013 SCIENCE PARK CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: (858) 922-0718 MAIL ADDRESS: STREET 1: 3013 SCIENCE PARK CITY: SAN DIEGO STATE: CA ZIP: 92121 SC 13G 1 goss-13gxsheilagujrathi021.htm SC 13G Document

United States
Securities and Exchange Commission
Washington, D.C. 20549
Schedule 13G
(Rule 13d-102)

Information to be Included in Statements Filed Pursuant
to § 240.13d-1(b), (c) and (d) and Amendments Thereto Filed
Pursuant to § 240.13d-2

UNDER THE SECURITIES EXCHANGE ACT OF 1934

(Amendment No. 1)*

GOSSAMER BIO, INC.
(Name of Issuer)

Common Stock
(Title of Class of Securities)
38341P102
(CUSIP Number)
December 31, 2020
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

☐    Rule 13d-1(b)
☐    Rule 13d-1(c)
☒    Rule 13d-1(d)
* The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).


CUSIP No. 38341P102Schedule 13G
Page 1 of 4

1
Names of Reporting Persons

Sheila Gujrathi

2
Check the Appropriate Box if a Member of a Group     (a) ☐
    (b) ☐
3SEC Use Only
4
Citizenship or Place of Organization

United States

Number of Shares Beneficially Owned by Each Reporting Person With5
Sole Voting Power

    3,606,441

6
Shared Voting Power

    0

7
Sole Dispositive Power

    3,606,441

8
Shared Dispositive Power

    0

9
Aggregate Amount Beneficially Owned by Each Reporting Person

    3,606,441

10
Check if the Aggregate Amount in Row (9) Excludes Certain Shares

    Not Applicable

11
Percent of Class Represented by Amount in Row 9

    4.8%

12
Type of Reporting Person

    IN


CUSIP No. 38341P102Schedule 13G
Page 2 of 4


ITEM 1.     (a)    Name of Issuer:
Gossamer Bio, Inc. (the “Issuer”).
(b)    Address of Issuer’s Principal Executive Offices:
3013 Science Park Road, San Diego, California 92121.
ITEM 2.    (a)    Name of Person Filing:
This statement is filed on behalf of Sheila Gujrathi (the “Reporting Person”).
(b)    Address or Principal Business Office:
The business address of the Reporting Person is 3013 Science Park Road, San Diego, California 92121.
(c)    Citizenship of each Reporting Person is:
The Reporting Person is a citizen of the United States.
(d)    Title of Class of Securities:
Common Stock, par value $0.0001 per share (“Common Stock”).
(e)    CUSIP Number:
38341P102
ITEM 3.    
Not applicable.
ITEM 4.    Ownership.
The ownership information below represents beneficial ownership of Common Stock of the Issuer as of December 31, 2020, based upon 75,524,254 shares of Common Stock outstanding as of December 31, 2020.
(a) Amount beneficially owned:
The Reporting Person may be deemed to beneficially own 3,606,441 shares of Common Stock held by a family trust of which the Reporting Person is a trustee.
(b) Percent of class: 4.8%


CUSIP No. 38341P102Schedule 13G
Page 3 of 4

(c) Number of shares as to which the person has:
(i)    Sole power to vote or to direct the vote: 3,606,441 
(ii)    Shared power to vote or direct the vote: 0
(iii)    Sole power to dispose or to direct the disposition of: 3,606,441
(iv)    Shared power to dispose or to direct the disposition of: 0
ITEM 5.    Ownership of Five Percent or Less of a Class.
If this statement is being filed to report the fact that as of the date hereof the Reporting Person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following: ☒
ITEM 6.    Ownership of More than Five Percent on Behalf of Another Person.
Not applicable.
ITEM 7.    Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company.
Not applicable.
ITEM 8.    Identification and Classification of Members of the Group.
Not applicable.
ITEM 9.    Notice of Dissolution of Group.
Not applicable.
ITEM 10.     Certification.
Not applicable.



CUSIP No. 38341P102Schedule 13G
Page 4 of 4

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Date:    February 12, 2021

Sheila Gujrathi

/s/ Sheila Gujrathi