Tim Kutzkey - Aug 11, 2021 Form 3 Insider Report for Surrozen, Inc./DE (SRZN)

Role
Director, 10%+ Owner
Signature
/s/ Sheela Mohan-Peterson, Attorney-in-Fact for Tim Kutzkey, Ph.D.
Stock symbol
SRZN
Transactions as of
Aug 11, 2021
Transactions value $
$0
Form type
3
Date filed
8/16/2021, 08:15 PM
Next filing
Jun 9, 2022

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding SRZN Common Stock 4.34M Aug 11, 2021 By The Column Group III, LP F1, F2
holding SRZN Common Stock 4.9M Aug 11, 2021 By The Column Group III-A, LP F3, F4

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 SRZN Common Stock Warrant (right to buy) Aug 11, 2021 Common Stock 78.3K $11.50 By The Column Group III, LP F2, F5
holding SRZN Common Stock Warrant (right to buy) Aug 11, 2021 Common Stock 88.4K $11.50 By The Column Group III-A, LP F4, F5
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Represents 4,108,427 shares of the Issuer's common stock received in exchange for shares of stock of Surrozen, Inc. ("Original Surrozen") in connection with the merger of Original Surrozen with and into a wholly owned subsidiary of the Issuer (the "Merger") and 234,818 shares of the Issuer's common stock underlying units purchased from the Issuer for $10.00 per unit (a "Unit"), with each unit consisting of one share of the Issuer's common stock and one-third of one redeemable warrant to purchase one share of the Issuer's common stock (the "Warrant").
F2 The securities are directly held by The Column Group III, LP ("TCG III LP"). The Column Group III GP, LP ("TCG III GP") is the general partner of TCG III LP and may be deemed to have voting, investment and dispositive power with respect to these securities. The managing partners of TCG III GP are David Goeddel, Peter Svennilson and the Reporting Person, a member of the Issuer's board of directors (collectively, the "Managing Partners"). The Managing Partners may be deemed to share voting and investment power with respect to such securities. TCG III GP and each of the Managing Partners disclaim beneficial ownership of these securities, except to the extent of their respective pecuniary interest in such securities.
F3 Represents 4,639,702 shares of the Issuer's common stock received in connection with the Merger and 265,182 shares of the Issuer's common stock underlying Units purchased from the Issuer.
F4 The securities are directly held by The Column Group III-A, LP ("TCG III-A LP"). TCG III GP is the general partner of TCG III-A LP and may be deemed to have voting, investment and dispositive power with respect to these securities. The managing partners of TCG III GP are the Managing Partners. The Managing Partners may be deemed to share voting and investment power with respect to such securities. TCG III GP and each of the Managing Partners disclaim beneficial ownership of these securities, except to the extent of their respective pecuniary interest in such securities.
F5 Each whole Warrant entitles the holder thereof to purchase one share of the Issuer's common stock at a price of $11.50 per share.