0001209191-23-038931.txt : 20230621 0001209191-23-038931.hdr.sgml : 20230621 20230621193858 ACCESSION NUMBER: 0001209191-23-038931 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220622 FILED AS OF DATE: 20230621 DATE AS OF CHANGE: 20230621 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: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38501 FILM NUMBER: 231031224 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Samsara BioCapital GP, LLC CENTRAL INDEX KEY: 0001888829 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38501 FILM NUMBER: 231031225 BUSINESS ADDRESS: STREET 1: 251 CHURCHILL AVENUE CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: (650) 843-5000 MAIL ADDRESS: STREET 1: 251 CHURCHILL AVENUE CITY: PALO ALTO STATE: CA ZIP: 94301 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Scholar Rock Holding Corp CENTRAL INDEX KEY: 0001727196 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 823750435 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 301 BINNEY STREET STREET 2: 3RD FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 857-259-3860 MAIL ADDRESS: STREET 1: 301 BINNEY STREET STREET 2: 3RD FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2022-06-22 0 0001727196 Scholar Rock Holding Corp SRRK 0001888829 Samsara BioCapital GP, LLC 628 MIDDLEFIELD ROAD PALO ALTO CA 94301 0 0 1 0 0001699737 Samsara BioCapital, L.P. 628 MIDDLEFIELD ROAD PALO ALTO CA 94301 0 0 1 0 Common Stock 4598828 I By Samsara BioCapital, L.P. Warrants to purchase Common Stock 7.35 2022-06-21 2025-12-31 Common Stock 1064804 I By Samsara BioCapital, L.P. Shares are held by Samsara BioCapital LP ("Samsara LP"). Samsara BioCapital GP, LLC ("Samsara LLC") is the general partner of Samsara LP and may be deemed to beneficially own the shares held by Samsara LP. Dr. Srinivas Akkaraju, MD, Ph.D. 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. Samsara LLC disclaims beneficial ownership in these shares except to the extent of its respective pecuniary interest therein. Dr. Akkaraju is a director of Issuer and files separate Section 16 reports. The warrants are exercisable subject to a beneficial ownership blocker provision that prevents the holder from exercising the warrants if such exercise would result in the holder beneficially owning more than 19.99% of the Issuer's Common Stock outstanding immediately following such exercise. Samsara BioCapital GP, LLC, By /s/ Srinivas Akkaraju, Managing Member 2023-06-21 Samsara BioCapital, L.P., By: Samsara BioCapital GP, LLC, its General Partner, By /s/ Srinivas Akkaraju, Managing Member 2023-06-21