SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 02/12/2020 | 3. Issuer Name and Ticker or Trading Symbol Revolution Medicines, Inc. [ RVMD ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Preferred Stock | (1) | (1) | Common Stock | 5,137,583(1) | (1) | D(2)(3)(4) | |
Series B Preferred Stock | (1) | (1) | Common Stock | 2,740,043(1) | (1) | D(2)(3)(5)(6)(7) | |
Series C Preferred Stock | (1) | (1) | Common Stock | 99,758(1) | (1) | D(2)(3)(8) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. The number of shares of common stock reflects a 1-for-4.8661 reverse stock split of the Issuer's common stock and preferred stock which became effective February 7, 2020. Each share of the Issuer's Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock is convertible into 1 share of the Issuer's common stock upon the closing of the Issuer's initial public offering (on an adjusted basis, after giving effect to the 1-for-4.8661 reverse stock split). Shares of Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock have no expiration date and will automatically convert into shares of the Issuer's common stock upon the closing of the Issuer's initial public offering of common stock, for no additional consideration. |
2. The securities are directly held by The Column Group III, LP ("TCG III LP"), and indirectly held by The Column Group III GP, LP ("TCG III GP"), the general partner of TCG III LP. The managing partners of TCG III GP are David Goeddel, Peter Svennilson and Tim Kutzkey. The managing partners of TCG III GP may be deemed to have voting and investment power with respect to such shares. TCG III GP and each individual managing partner disclaims beneficial ownership of these shares, except to the extent of their respective pecuniary interest in such shares. |
3. The securities are directly held by The Column Group III-A, LP ("TCG III-A LP"), and indirectly held by TCG III GP, the general partner of TCG III-A LP. The managing partners of TCG III GP are David Goeddel, Peter Svennilson and Tim Kutzkey. The managing partners of TCG III GP may be deemed to have voting and investment power with respect to such shares. TCG III GP and each individual managing partner disclaims beneficial ownership of these shares, except to the extent of their respective pecuniary interest in such shares. |
4. Consists of 2,412,789 shares held directly by TCG III LP and 2,724,794 shares held directly by TCG III-A LP. |
5. The securities are directly held by Ponoi Capital, LP ("Ponoi LP"), and indirectly held by Ponoi Management, LLC ("Ponoi LLC"), the general partner of Ponoi LP. The managing partners of Ponoi LLC are David Goeddel, Peter Svennilson and Tim Kutzkey. The managing partners of Ponoi LLC may be deemed to have voting and investment power with respect to such shares. Ponoi LLC and each individual managing partner disclaims beneficial ownership of these shares, except to the extent of their respective pecuniary interest in such shares. |
6. The securities are directly held by Ponoi Capital II, LP ("Ponoi II LP"), and indirectly held by Ponoi II Management, LLC ("Ponoi II LLC"), the general partner of Ponoi II LP. The managing partners of Ponoi II LLC are David Goeddel, Peter Svennilson and Tim Kutzkey. The managing partners of Ponoi II LLC may be deemed to have voting and investment power with respect to such shares. Ponoi II LLC and each individual managing partner disclaims beneficial ownership of these shares, except to the extent of their respective pecuniary interest in such shares. |
7. Consists of 643,410 shares held directly by TCG III LP, 726,611 shares held directly by TCG III-A LP, 685,011 shares held directly by Ponoi LP and 685,011 shares held directly by Ponoi II LP. |
8. Consists of 46,850 shares held directly by TCG III LP and 52,908 shares held directly by TCG III-A LP. |
Remarks: |
Exhibit List 1. Exhibit 24.1 - Power of Attorney: The Column Group III, LP 2. Exhibit 24.2 - Power of Attorney: The Column Group III-A, LP 3. Exhibit 24.3 - Power of Attorney: The Column Group III GP, LP |
/s/ Jennifer J. Carlson, Attorney-in-Fact | 02/12/2020 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |