0001415889-24-019802.txt : 20240718 0001415889-24-019802.hdr.sgml : 20240718 20240718200654 ACCESSION NUMBER: 0001415889-24-019802 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240718 FILED AS OF DATE: 20240718 DATE AS OF CHANGE: 20240718 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Schwab Andrew J. CENTRAL INDEX KEY: 0001598549 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-42179 FILM NUMBER: 241125809 MAIL ADDRESS: STREET 1: C/O 5AM VENTURES STREET 2: 501 2ND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PARMAR KUSH CENTRAL INDEX KEY: 0001664281 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-42179 FILM NUMBER: 241125810 MAIL ADDRESS: STREET 1: C/O 5AM VENTURES STREET 2: 501 2ND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 5AM Partners VI, LLC CENTRAL INDEX KEY: 0001829051 ORGANIZATION NAME: STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-42179 FILM NUMBER: 241125812 BUSINESS ADDRESS: STREET 1: 501 2ND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: (415) 993-8565 MAIL ADDRESS: STREET 1: 501 2ND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 5AM Ventures VI, L.P. CENTRAL INDEX KEY: 0001753037 ORGANIZATION NAME: STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-42179 FILM NUMBER: 241125811 BUSINESS ADDRESS: STREET 1: 501 2ND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: (415) 993-8565 MAIL ADDRESS: STREET 1: 501 2ND STREET, SUITE 350 CITY: SAN FRANCISCO STATE: CA ZIP: 94107 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Artiva Biotherapeutics, Inc. CENTRAL INDEX KEY: 0001817241 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 863614316 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5505 MOREHOUSE DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: (858) 267-4467 MAIL ADDRESS: STREET 1: 5505 MOREHOUSE DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92121 3 1 form3-07192024_120751.xml X0206 3 2024-07-18 0 0001817241 Artiva Biotherapeutics, Inc. ARTV 0001829051 5AM Partners VI, LLC 4 EMBARCADERO CENTER, SUITE 3110 SAN FRANCISCO CA 94111 false false true false 0001753037 5AM Ventures VI, L.P. 4 EMBARCADERO CENTER, SUITE 3110 SAN FRANCISCO CA 94111 0 0 1 0 0001664281 PARMAR KUSH C/O 5AM VENTURE MANAGEMENT, LLC 4 EMBARCADERO CENTER, SUITE 3110 SAN FRANCISCO CA 94111 0 0 1 0 0001598549 Schwab Andrew J. C/O 5AM VENTURE MANAGEMENT, LLC 4 EMBARCADERO CENTER, SUITE 3110 SAN FRANCISCO CA 94111 0 0 1 0 Series A Preferred Stock Common Stock 843592 I By 5AM Ventures VI, L.P. Series B Preferred Stock Common Stock 214692 I By 5AM Ventures VI, L.P. Each share of Series A Preferred Stock and Series B Preferred Stock (collectively, the "Preferred Stock") is convertible into shares of Common Stock of the Issuer on a one-for-one basis without payment of further consideration. Upon the closing of the Issuer's initial public offering, the Preferred Stock will convert into the number of shares of Common Stock of the Issuer shown in column 3. The Preferred Stock has no expiration date. The shares are directly held by 5AM Ventures VI, L.P. ("Ventures VI"). 5AM Partners VI, LLC ("Partners VI") is the sole general partner of Ventures VI. Dr. Kush Parmar and Andrew J. Schwab are the managing members of Partners VI and may be deemed to have shared voting and investment power over the shares beneficially owned by Ventures VI. Each of Partners VI, Dr. Parmar, and Mr. Schwab disclaims beneficial ownership of such shares except to the extent of its or his respective pecuniary interest therein. 5AM Ventures VI, L.P., By: 5AM Partners VI, LLC, its General Partner, By /s/ Kush Parmar, Managing Member 2024-07-18 5AM Partners VI, LLC, By /s/ Kush Parmar, Managing Member 2024-07-18 /s/ Kush Parmar 2024-07-18 /s/ Andrew J. Schwab 2024-07-18