Filing Details

Accession Number:
0001209191-18-025823
Form Type:
4
Zero Holdings:
No
Publication Time:
2018-04-23 16:16:01
Reporting Period:
2018-04-23
Accepted Time:
2018-04-23 16:16:01
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1718108 Surface Oncology Inc. SURF () 4
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1656151 Armen Shanafelt C/O Lilly Ventures
115 West Washington St., Ste 1680 South
Indianapolis IN 46204
Yes No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2018-04-23 3,181,817 $0.00 3,181,817 No 4 C Indirect See Footnote
Common Stock Acquisiton 2018-04-23 266,000 $15.00 3,447,817 No 4 P Indirect See Footnote
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect See Footnote
No 4 P Indirect See Footnote
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series A Preferred Stock Disposition 2018-04-23 7,000,000 $0.00 3,181,817 $0.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Indirect
Footnotes
  1. The Series A Preferred Stock automatically converted into the Issuer's common stock on a 2.2-for-1 basis at the closing of the Issuer's initial publicoffering without payment or further consideration and had no expiration date.
  2. These shares are held directly by Lilly Ventures Fund I, LLC (LVFI). LV Management Group, LLC (LVMG) is the management company for LVFI and has voting and dispositive power over the shares held by LVFI. As such, LVMG may be deemed to indirectly beneficially own the shares held by LVFI. LVMG's voting and dispositive decisions with respect to the shares held by LVFI are made by LVMG's management committee, which includes the Reporting Person. The Reporting Person disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein.