Samsara BioCapital, L.P. - Jun 29, 2021 Form 4 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 29, 2021
Transactions value $
$8,500,000
Form type
4
Date filed
7/1/2021, 05:39 PM
Previous filing
Jun 24, 2021
Next filing
Oct 8, 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction GRPH Common Stock Conversion of derivative security +6.17M 6.17M Jun 29, 2021 By Fund F1, F2
transaction GRPH Common Stock Conversion of derivative security +741K +12.02% 6.91M Jun 29, 2021 By Fund F1, F2
transaction GRPH Common Stock Conversion of derivative security +22.8K 22.8K Jun 29, 2021 By Fund F1, F3
transaction GRPH Common Stock Purchase $8.25M +485K +7.02% $17.00 7.39M Jun 29, 2021 By Fund F2
transaction GRPH Common Stock Purchase $255K +15K +65.93% $17.00 37.8K Jun 29, 2021 By Fund F3

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
transaction GRPH Series A Redeemable Convertible Preferred Stock Conversion of derivative security $0 -15M -100% $0.00* 0 Jun 29, 2021 Common Stock 6.17M By Fund F1, F2
transaction GRPH Series B Redeemable Convertible Preferred Stock Conversion of derivative security $0 -1.8M -100% $0.00* 0 Jun 29, 2021 Common Stock 741K By Fund F1, F2
transaction GRPH Series B Redeemable Convertible Preferred Stock Conversion of derivative security $0 -55.3K -100% $0.00* 0 Jun 29, 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 the redeemable convertible preferred stock automatically converted into shares of Common Stock immediately prior to the closing of the Issuer's initial public offering (the "IPO") for no additional consideration, on a one-for-2.432 basis, and had 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.