SEC Form 4 · accession 0001209191-18-025823

Surface Oncology, Inc. · SURF

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director · 10% Owner

Period of report

Apr 23, 2018

Accepted (ET)

Apr 23, 2018 · 4:16 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001718108

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	Apr 23, 2018	C	3,181,817	—	A	3,181,817	I	See Footnote
Common Stock^F2	Apr 23, 2018	P	266,000	$15.00	A	3,447,817	I	See Footnote

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Series A Preferred Stock^F1,F2	—	Apr 23, 2018	C	7,000,000	D	—	—	Common Stock	3,181,817	0	I

F1The 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 public offering without payment or further consideration and had no expiration date.
F2These 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.