Samsara BioCapital, L.P. - Jun 24, 2021 Form 3 Insider Report for Graphite Bio, Inc. (GRPH)

Role
10%+ Owner
Signature
Samsara BioCapital, L.P., By: Samsara BioCapital GP, LLC, its General Partner, By /s/ Srinivas Akkaraju, Managing Member
Stock symbol
GRPH
Transactions as of
Jun 24, 2021
Transactions value $
$0
Form type
3
Date filed
6/24/2021, 07:17 PM
Next filing
Jul 1, 2021

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
holding GRPH Series A Redeemable Convertible Preferred Stock Jun 24, 2021 Common Stock 6.17M By Fund F1, F2
holding GRPH Series B Redeemable Convertible Preferred Stock Jun 24, 2021 Common Stock 741K By Fund F1, F2
holding GRPH Series B Redeemable Convertible Preferred Stock Jun 24, 2021 Common Stock 22.8K By Fund F1, F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Each share of redeemable convertible preferred stock is convertible on a one-for-2.432 basis into Common Stock at any time at the holder's election. The redeemable convertible preferred stock will convert automatically upon the closing of the Issuer's initial public offering and has no expiration date.
F2 Shares held by Samsara BioCapital, L.P. ("Samsara LP"). Samsara BioCapital GP, LLC ("Samsara LLC") is the general partner of Samsara LP and may be deemed to beneficially own the shares held by Samsara LP. Dr. Srinivas Akkaraju, MD, Ph.D. has voting and investment power over the shares held by Samsara LP and, accordingly, may be deemed to beneficially own the shares held by Samsara LP. Each of Samsara LLC and Dr. Akkaraju disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein.
F3 Shares held by 436, L.P. ("436 LP"). 436, LLC ("436 LLC") is the general partner of 436 LP and may be deemed to beneficially own the shares held by 436 LP. Dr. Srinivas Akkaraju, MD, Ph.D. has voting and investment power over the shares held by 436 LP and, accordingly, may be deemed to beneficially own the shares held by 436 LP. Each of 436 LLC and Dr. Akkaraju disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein.