0001209191-19-009430.txt : 20190212 0001209191-19-009430.hdr.sgml : 20190212 20190212173311 ACCESSION NUMBER: 0001209191-19-009430 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190212 FILED AS OF DATE: 20190212 DATE AS OF CHANGE: 20190212 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Giraudo Bryan CENTRAL INDEX KEY: 0001740847 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38796 FILM NUMBER: 19592240 MAIL ADDRESS: STREET 1: 7707 GATEWAY BOULEVARD, SUITE 140 CITY: NEWARK STATE: CA ZIP: 94560 ISSUER: 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 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-02-12 0 0001728117 Gossamer Bio, Inc. GOSS 0001740847 Giraudo Bryan 3013 SCIENCE PARK ROAD SAN DIEGO CA 92121 0 1 0 0 Chief Financial Officer Common Stock 2019-02-12 4 C 0 17879 A 17879 D Common Stock 2019-02-12 4 P 0 6000 16.00 A 23879 D Series A Preferred Stock 2019-02-12 4 C 0 57142 D Common Stock 12698 0 D Series B Preferred Stock 2019-02-12 4 C 0 23316 D Common Stock 5181 0 D The shares of the Issuer's Series A Preferred Stock and Series B Preferred Stock automatically converted into shares of the Issuer's Common Stock, for no additional consideration, at a ratio of 4.5 to one share, immediately prior to the consummation of the Issuer's initial public offering. The Series A Preferred Stock and Series B Preferred Stock had no expiration date. /s/ Jeff Boerneke, Attorney-in-Fact 2019-02-12