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Nestle SA, et al. – ‘3’ for 3/11/21 re: Prometheus Biosciences, Inc.

On:  Friday, 3/12/21, at 7:20am ET   ·   For:  3/11/21   ·   Accession #:  899243-21-11267   ·   File #:  1-40187

Previous ‘3’:  ‘3’ on 4/24/20 for 12/31/18   ·   Latest ‘3’:  This Filing

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 3/12/21  Nestle SA                         3                      1:9K   Prometheus Biosciences, Inc.      Donnelley Fin’l S… 06/FA
          Societe des Produits Nestle S.A.

Initial Statement of Beneficial Ownership of Securities by an Insider   —   Form 3   —   SEA’34
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 3           Form 3 Submission -- doc3.xml/2.6                   HTML      3K 




        

This ‘3’ Document is an XML Data File that may be rendered in various formats:

  Form 3    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 

 
SEC Info rendering:  Form 3 Submission
 
FORM 3UNITED 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
OMB APPROVAL
OMB Number:3235-0104
Estimated average burden
hours per response:0.5
1. Name and Address of Reporting Person*
NESTLE SA

(Last)(First)(Middle)
AVENUE NESTLE 55

(Street)
CH-1800, VEVEYV8

(City)(State)(Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
3/11/21
3. Issuer Name and Ticker or Trading Symbol
Prometheus Biosciences, Inc. [ RXDX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
DirectorX10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
XForm 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)
Date ExercisableExpiration DateTitleAmount or Number of Shares
Series C Convertible Preferred Stock (1) (1)Common Stock2,500,000 (1)ISee Footnote (4) (5)
Series D-1 Convertible Preferred Stock (2) (2)Common Stock508,885 (2)ISee Footnote (4) (5)
Series D-2 Convertible Preferred Stock (3) (3)Common Stock721,956 (3)ISee Footnote (4) (5)
1. Name and Address of Reporting Person*
NESTLE SA

(Last)(First)(Middle)
AVENUE NESTLE 55

(Street)
CH-1800, VEVEYV8

(City)(State)(Zip)
1. Name and Address of Reporting Person*
Societe des Produits Nestle S.A.

(Last)(First)(Middle)
AVENUE NESTLE 55

(Street)
CH-1800, VEVEYV8

(City)(State)(Zip)
Explanation of Responses:
(1)  Shares of Series C Preferred Stock are convertible at any time, at the holder's election, at a ratio of ten-for-one share of the Issuer's common stock. In addition, effective immediately prior to the closing of the Issuer's initial public offering of its common stock, each share of Series C Preferred Stock will automatically convert at the ratio of ten-for-one share of the Issuer's common stock. The Series C Preferred Stock has no expiration date.
(2)  Shares of Series D-1 Preferred Stock are convertible at any time, at the holder's election, at a ratio of ten-for-one share of the Issuer's common stock. In addition, effective immediately prior to the closing of the Issuer's initial public offering of its common stock, each share of Series D-1 Preferred Stock will automatically convert at the ratio of ten-for-one share of the Issuer's common stock. The Series D-1 Preferred Stock has no expiration date.
(3)  Shares of Series D-2 Preferred Stock are convertible at any time, at the holder's election, at a ratio of ten-for-one share of the Issuer's common stock. In addition, effective immediately prior to the closing of the Issuer's initial public offering of its common stock, each share of Series D-2 Preferred Stock will automatically convert at the ratio of ten-for-one share of the Issuer's common stock. The Series D-2 Preferred Stock has no expiration date.
(4)  The shares reported herein represent, (i) 855,000 shares of Series C Preferred Stock held by Nestle Health Science US Holdings, Inc. ("NHS"), (ii) 508,885 shares of Series D-1 Preferred Stock held by NHS, (iii) 721,956 shares of Series D-2 Preferred Stock held by NHS and (iv) 1,645,000 shares of Series C Preferred Stock held by Societe des Produits Nestle S.A. ("SPN"). NHS is a wholly owned subsidiary of NIMCO US, Inc. ("NIMCO"). NIMCO, in turn, is a wholly-owned subsidiary of Nestle US Holdco, Inc. ("Nestle US Holdco"), which is a wholly-owned subsidiary of SPN. The ultimate parent company of NHS, NIMCO, Nestle US Holdco and SPN is Nestle S.A. ("Nestle"). Each of these entities may be deemed to share voting and investment power with respect to all shares of Series C Preferred Stock, Series D-1 Preferred Stock and Series D-2 Preferred Stock held by NHS.
(5)  (Continued from Footnote 4) Additionally, Nestle may be deemed to share voting and investment power with respect to all shares of Series C Preferred Stock held by SPN.
Remarks:
SOCIETE DES PRODUITS NESTLE S.A. By: /s/ Claudio Kuoni, Name: Claudio Kuoni, Title: Vice President 3/11/21
NESTLE S.A. By: /s/ Gregory Behar, Name: Gregory Behar, Title: Deputy Executive Vice President 3/11/21
** Signature of Reporting PersonDate
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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

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