0000899243-20-028346.txt : 20201015 0000899243-20-028346.hdr.sgml : 20201015 20201015172710 ACCESSION NUMBER: 0000899243-20-028346 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201014 FILED AS OF DATE: 20201015 DATE AS OF CHANGE: 20201015 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Thomson Erin Ator CENTRAL INDEX KEY: 0001827202 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39593 FILM NUMBER: 201242184 MAIL ADDRESS: STREET 1: 1018 W 11TH ST., SUITE 100 CITY: AUSTIN STATE: TX ZIP: 78703 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Shattuck Labs, Inc. CENTRAL INDEX KEY: 0001680367 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 812575858 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1018 W. 11TH STREET CITY: AUSTIN STATE: TX ZIP: 78703 BUSINESS PHONE: 919-864-2700 MAIL ADDRESS: STREET 1: 1018 W. 11TH STREET CITY: AUSTIN STATE: TX ZIP: 78703 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-10-14 0 0001680367 Shattuck Labs, Inc. STTK 0001827202 Thomson Erin Ator C/O SHATTUCK LABS, INC. 1018 W. 11TH STREET, SUITE 100 AUSTIN TX 78703 0 1 0 0 General Counsel Common Stock 2020-10-14 4 C 0 1096 A 104307 D Series A Preferred Stock 2020-10-14 4 C 0 160 0.00 D Common Stock 1096 0 D Each share of Series A Preferred Stock automatically converted into 6.85 shares of the Issuer's common stock immediately prior to the closing of the Issuer's initial public offering and had no expiration date. /s/ Erin Ator Thomson 2020-10-15