0001140361-21-036636.txt : 20211104 0001140361-21-036636.hdr.sgml : 20211104 20211104213221 ACCESSION NUMBER: 0001140361-21-036636 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20211104 FILED AS OF DATE: 20211104 DATE AS OF CHANGE: 20211104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Andersson Claus A. CENTRAL INDEX KEY: 0001890710 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41008 FILM NUMBER: 211382022 MAIL ADDRESS: STREET 1: 1209 ORANGE STREET CITY: WILMINGTON STATE: DE ZIP: 19801 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IO Biotech, Inc. CENTRAL INDEX KEY: 0001865494 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 870909276 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: OLE MAALOES VEH 3 CITY: COPENHAGEN STATE: G7 ZIP: 2200 BUSINESS PHONE: 4570702980 MAIL ADDRESS: STREET 1: OLE MAALOES VEH 3 CITY: COPENHAGEN STATE: G7 ZIP: 2200 3 1 form3.xml FORM 3 X0206 3 2021-11-04 0 0001865494 IO Biotech, Inc. IOBT 0001890710 Andersson Claus A. C/O IO BIOTECH, INC. OLE MAALOES VEH 3 COPENHAGEN G7 2200 DENMARK true Series B Preferred Stock Common Stock 1361660 I See footnote Series C Preferred Stock Common Stock 354830 I See footnote Upon the closing of the Issuer's initial public offering ("IPO"), each share of Series B Preferred Stock beneficially owned by the reporting person will automatically convert, for no additional consideration, into the number of shares of Common Stock reported in Column 3. These shares of Series B Preferred Stock have no expiration date. Upon the closing of the Issuer's initial public offering ("IPO"), each share of Series C Preferred Stock beneficially owned by the reporting person will automatically convert, for no additional consideration, into the number of shares of Common Stock reported in Column 3. These shares of Series C Preferred Stock have no expiration date. Sunstone Life Science Ventures Fund III K/S ("Sunstone Fund III"). Sunstone LSV General Partner III ApS ("Sunstone LSV GP III") is the general partner of Sunstone Fund III and has voting and dispositive power over all of the shares of held by Sunstone Fund III. The reporting person is a General Partner of Sunstone Life Science Ventures A/S and a member of the executive board of Sunstone LSV GP III, and shares voting and dispositive power with respect to the shares held by Sunstone Fund III. The reporting person disclaims beneficial ownership of the shares held directly by Sunstone Fund III except to the extent of his pecuniary interest therein. Exhibit List: Exhibit 24 - Power of Attorney /s/ Brian Burkavage, Attorney-in-Fact for Claus Andersson 2021-11-04 EX-24 2 andersson.htm EXHIBIT 24
POWER OF ATTORNEY
 
Know all by these presents, that the undersigned hereby makes, constitutes and appoints each of Keith Vendola, Mai-Britt Zocca, and Brian Burkavage, or any of them acting individually, and with full power of substitution, the undersigned's true and lawful attorney-in-fact to:
 

 (1)
prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC;
 

 (2)
execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of IO Biotech, Inc., a Delaware corporation (the "Company"), Forms 3, 4, and 5, including amendments thereto, in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules and regulations thereunder;
 

 (3)
do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and
 

 (4)
take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.
 
The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier (a) revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact or (b) superseded by a new power of attorney regarding the purposes outlined herein at a later date.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 25th day of October, 2021.


 
 
 /s/ Claus A. Andersson
 
 
 
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 Claus A. Andersson
 
 
 
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