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) 07/29/2021 | 3. Issuer Name and Ticker or Trading Symbol Tenaya Therapeutics, Inc. [ TNYA ] | |||||||||||||
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) |
Common Stock | 191,666 | D | |
Common Stock | 141,666 | I | See Footnotes(1) |
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 | ||||
Stock Option (Right to Buy) | (2) | 12/06/2029 | Common Stock | 37,500 | 2.7 | D |
Explanation of Responses: |
1. These shares are held directly by The J. David Gladstone Institutes for which the Reporting Person serves as President. The Reporting Person may be deemed to have voting and investment control over the shares. The Reporting Person disclaims beneficial ownership of these shares. This report shall not be deemed an admission that the Reporting Person is the beneficial owner of any of the shares held by The J. David Gladstone Institutes for Section 16 or any other purpose. |
2. 1/48th of the shares subject to the option granted on December 6, 2019 became vested and exercisable as of November 6, 2019 and 1/48th of the shares subject to the option shall vest monthly thereafter, provided that the Reporting Person remains a service provider to the issuer on each such vest date. |
Remarks: |
Date set forth above represents the effective date of the Issuer's initial public offering |
/s/ Leone Patterson Attorney-in-Fact for Deepak Srivastava | 07/29/2021 | |
** 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. |