Lightspeed Venture Partners Select IV Form 3 Personalis / Arif Janmohamed ownership change

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^*

Lightspeed Venture Partners Select IV, L.P.

(Last) (First) (Middle)

2200 SAND HILL ROAD

(Street)

MENLO PARK CA 94025

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
06/01/2020

3. Issuer Name and Ticker or Trading Symbol
Personalis, Inc. [ PSNL ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director		10% Owner
	Officer (give title below)	X	Other (specify below)
Affiliate of 10% Owner

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

	Form filed by One Reporting Person
X	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
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)
Common Stock	77,797	I	See footnote(1)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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

1. Name and Address of Reporting Person^*

Lightspeed Venture Partners Select IV, L.P.

(Last) (First) (Middle)

2200 SAND HILL ROAD

(Street)

MENLO PARK CA 94025

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

Lightspeed General Partner Select IV, L.P.

(Last) (First) (Middle)

2200 SAND HILL ROAD

(Street)

MENLO PARK CA 94025

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

Lightspeed Ultimate General Partner Select IV, L.L.C.

(Last) (First) (Middle)

2200 SAND HILL ROAD

(Street)

MENLO PARK CA 94025

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

Janmohamed Arif

(Last) (First) (Middle)

2200 SAND HILL ROAD

(Street)

MENLO PARK CA 94025

(City) (State) (Zip)

Explanation of Responses:

1. Shares held by Lightspeed Venture Partners Select IV, L.P. ("Lightspeed Select IV"). Lightspeed General Partner Select IV, L.P. ("LGP Select IV") is the general partner of Lightspeed Select IV. Lightspeed Ultimate General Partner Select IV, L.L.C. ("LUGP Select IV") is the general partner of LGP Select IV. Jeremy Liew, Ravi Mhatre and Arif Janmohamed are the managers of LUGP Select IV and share voting and dispositive power with respect to the shares held by Lightspeed Select IV. LGP Select IV, LUGP Select IV and Messrs. Liew, Mhatre and Janmohamed disclaim beneficial ownership of the shares held by Lightspeed Select IV except to the extent of their respective pecuniary interests therein.

Remarks:

	LIGHTSPEED VENTURE PARTNERS SELECT IV, L.P. By: Lightspeed General Partner Select IV, L.P., its general partner By: Lightspeed Ultimate General Partner Select IV, L.L.C., its general partner By: /s/ Ravi Mhatre Duly Authorized Signatory	06/03/2020
	LIGHTSPEED GENERAL PARTNER SELECT IV, L.P. By: Lightspeed Ultimate General Partner Select, L.L.C., its general partner By: /s/ Ravi Mhatre Duly Authorized Signatory	06/03/2020
	LIGHTSPEED ULTIMATE GENERAL PARTNER SELECT IV, L.L.C., By: /s/ Ravi Mhatre Duly Authorized Signatory	06/03/2020
	/s/ Arif Janmohamed	06/03/2020
	** 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).
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