SEC FORM 3 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*
Versant Venture Capital VI, L.P.

(Last) (First) (Middle)
ONE SANSOME STREET, SUITE 3630

(Street)
SAN FRANCISCO CA 94101

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/23/2021
3. Issuer Name and Ticker or Trading Symbol
Monte Rosa Therapeutics, Inc. [ GLUE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% 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
X 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)
Common Stock 283,246 D(1)
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 Exercisable Expiration Date Title Amount or Number of Shares
Series A convertible preferred stock (2) (2) Common Stock 5,666,131 (2) D(1)
Series B convertible preferred stock (2) (2) Common Stock 849,738 (2) D(1)
Series B convertible preferred stock (2) (2) Common Stock 1,175,470 (2) I By Versant Vantage I, L.P.(3)
Series C convertible preferred stock (2) (2) Common Stock 764,573 (2) I By Versant Vantage I, L.P.(3)
1. Name and Address of Reporting Person*
Versant Venture Capital VI, L.P.

(Last) (First) (Middle)
ONE SANSOME STREET, SUITE 3630

(Street)
SAN FRANCISCO CA 94101

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Versant Ventures VI GP, L.P.

(Last) (First) (Middle)
ONE SANSOME STREET, SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Versant Ventures VI GP-GP, LLC

(Last) (First) (Middle)
ONE SANSOME STREET, SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Versant Vantage I, L.P.

(Last) (First) (Middle)
ONE SANSOME STREET, SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Versant Vantage I GP, L.P.

(Last) (First) (Middle)
ONE SANSOME STREET, SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Versant Vantage I GP-GP, LLC

(Last) (First) (Middle)
ONE SANSOME STREET, SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
Explanation of Responses:
1. Shares held by Versant Venture Capital VI, L.P. ("Versant VI"). Versant Ventures VI GP, L.P. ("Versant Ventures VI GP") is the general partner of Versant VI, and Versant Ventures VI GP-GP, LLC ("Versant Ventures VI GP GP") is the general partner of Versant Ventures VI GP. Bradley J. Bolzon, a member of the Issuer's board of directors, is a managing member of Versant Ventures VI GP-GP and may be deemed to share voting and dispositive power over the shares held by Versant VI. Each of Versant Ventures VI GP, Versant Ventures VI GP-GP and Bradley J. Bolzon disclaim beneficial ownership of such securities, except to the extent of their pecuniary interests therein. Bradley J. Bolzon is a director of the Issuer and, accordingly, files separate Section 16 reports.
2. Each share of Series A convertible preferred stock, Series B convertible preferred stock and Series C convertible preferred stock (collectively, the "Preferred Stock") is convertible into shares of the Issuer's Common Stock on a 3.5305-for-one basis. Upon the closing of the Issuer's initial public offering, all shares of Preferred Stock will convert into the number of shares of Common Stock of the Issuer shown in column 3. The Preferred Stock has no expiration date.
3. Shares held by Versant Vantage I, L.P. ("Versant Vantage I"). Versant Vantage I GP, L.P. ("Versant Vantage I GP") is the general partner of Versant Vantage I, and Versant Vantage I GP-GP, LLC ("Versant Vantage I GP-GP") is the general partner of Versant Vantage I GP. Bradley J. Bolzon is a managing member of Versant Vantage I GP-GP and may be deemed to share voting and dispositive power over the shares held by Versant Vantage I. Each of Versant Vantage I GP, Versant Vantage I GP-GP and Bradley J. Bolzon disclaim beneficial ownership of such securities, except to the extent of their respective pecuniary interests therein. Bradley J. Bolzon is a director of the Issuer and, accordingly, files separate Section 16 reports.
Remarks:
Versant Venture Capital VI, L.P. By: Versant Ventures VI GP, L.P. Its: General Partner By: Versant Ventures VI GP-GP, LLC By: /s/ Robin L. Praeger Its: Managing Director 06/23/2021
Versant Ventures VI GP, L.P., By: Versant Ventures VI GP-GP, LLC By: /s/ Robin L. Praeger Its: Managing Director 06/23/2021
Versant Ventures VI GP-GP, LLC By: /s/ Robin L. Praeger Its: Managing Director 06/23/2021
Versant Vantage I, LP By: Versant Vantage I GP, L.P. Its: General Partner By: Versant Vantage I GP-GP, LLC Its: General Partner By: /s/ Robin L. Praeger Its: Managing Director 06/23/2021
Versant Vantage I GP, L.P., By: Versant Vantage I GP-GP, LLC Its: General Partner By: /s/ Robin L. Praeger Its: Managing Director 06/23/2021
Versant Vantage I GP-GP, LLC, By: /s/ Robin L. Praeger Its: Managing Director 06/23/2021
** 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).
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