Filing Details

Accession Number:
0001209191-18-025824
Form Type:
4
Zero Holdings:
No
Publication Time:
2018-04-23 16:16:47
Reporting Period:
2018-04-23
Accepted Time:
2018-04-23 16:16:47
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
1552293 Edward S. Torres 115 West Washington Street
Suite 1680-South
Indianapolis IN 46204
No No Yes No
1575852 Lilly Ventures Fund I Llc 115 West Washington Street
Suite 1680-South
Indianapolis IN 46204
No No Yes No
1602732 Edward Steven Hall 115 West Washington Street
Suite 1680-South
Indianapolis IN 46204
No No Yes No
1681884 Lv Management Group, Llc 115 West Washington Street
Suite 1680-South
Indianapolis IN 46204
No 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 By Fund
Common Stock Acquisiton 2018-04-23 266,000 $15.00 3,447,817 No 4 P Indirect By Fund
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect By Fund
No 4 P Indirect By Fund
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 LVFIand has voting and dispositive power over the shares held by LVFI. As such, LVMG may be deemed to indirectly beneficially own the sharesheld by LVFI. LVMG's voting and dispositive decisions with respect to the shares held by LVFI are made by LVMG's management committee,which consists of S. Edward Torres, Dr. Steven E. Hall and Dr. Armen B. Shanafelt. Each of the individuals and entities listed above expressly disclaimsbeneficial ownership of the shares held by LVFI, except to the extent of his or its pecuniary interest therein. Dr. Shanafelt is a director of theIssuer and, accordingly, files separate Section 16 reports.