SEC Filing | 4D Molecular Therapeutics

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SEC FORM 3/A 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^*

YAO TONY DUNG LING

(Last)

(First)

(Middle)

C/O 4D MOLECULAR THERAPEUTICS INC.

5858 HORTON STREET #455

(Street)

EMERYVILLE

94608

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
12/10/2020

3. Issuer Name and Ticker or Trading Symbol
4D Molecular Therapeutics Inc. [ FDMT ]

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

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

5. If Amendment, Date of Original Filed (Month/Day/Year)
12/10/2020

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

X	Form filed by One Reporting Person
	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)

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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Series B Preferred Stock	⁽¹⁾	⁽²⁾	Common Stock	2,864	⁽¹⁾	D
Series B Preferred Stock	⁽¹⁾	⁽²⁾	Common Stock	455,326	⁽¹⁾	I	See Footnote⁽³⁾
Series C Preferred Stock	⁽⁴⁾	⁽²⁾	Common Stock	180,554	⁽⁴⁾	I	See Footnote⁽³⁾

Explanation of Responses:

1. The shares of the Issuer's Series B Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1 basis immediately upon the consummation of the Issuer's initial public offering.

2. The expiration date is not relevant to the conversion of these securities.

3. These securities are held of record by ArrowMark Life Science Fund, LP, ArrowMark Fundamental Opportunity Fund L.P., CF Ascent LLC, Iron Horse Investments, LLC, Lookfar Investments, LLC, Meridian Small Cap Growth Fund and THB Iron Rose, LLC Life Science Portfolio (together, the "ArrowMark Funds"). ArrowMark Colorado Holdings LLC ("ArrowMark Colorado") is an investment advisor to the ArrowMark Funds. The reporting person is employed as a portfolio manager for ArrowMark Colorado and has direct voting and dispositive control over the shares held by the ArrowMark Funds. The reporting person disclaims beneficial ownership of these securities except to the extent of any pecuniary interest therein.

4. The shares of the Issuer's Series C Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1 basis immediately upon the consummation of the Issuer's initial public offering.

Remarks:

Amendment made to include shares indirectly held by reporting owner.

	/s/ August J. Moretti, Attorney-in-Fact for Tony Dung Ling Yao	12/10/2020
	** 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).
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