Sec Form 3 Filing - Klausner Richard @ Lyell Immunopharma, Inc. - 2021-06-16

Insider filing report for Changes in Beneficial Ownership
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FORM 3
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Klausner Richard
2. Issuer Name and Ticker or Trading Symbol
Lyell Immunopharma, Inc. [ LYEL]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Executive Chairman
(Last) (First) (Middle)
C/O LYELL IMMUNOPHARMA, INC., 400 EAST JAMIE COURT, SUITE 301
3. Date of Earliest Transaction (MM/DD/YY)
06/16/2021
(Street)
SOUTH SAN FRANCISCO, CA94080
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 2,967,834 ( 1 ) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option (right to buy) $ 0.1 ( 2 ) 11/05/2028 Common Stock 2,713,756 D
Option (right to buy) $ 3.65 ( 3 ) 01/15/2030 Common Stock 650,000 D
Option (right to buy) $ 3.65 ( 4 ) 08/30/2029 Common Stock 4,675,392 D
Series A Convertible Preferred Stock $ 1.8288 ( 5 ) ( 5 ) Common Stock 3,765,842 I Lyell Investors, LLC ( 6 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Klausner Richard
C/O LYELL IMMUNOPHARMA, INC.
400 EAST JAMIE COURT, SUITE 301
SOUTH SAN FRANCISCO, CA94080
X Executive Chairman
Signatures
/s/ Heather D. Turner, as Attorney-in-fact 06/16/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )1/4 of the shares vested on August 1, 2019, with the remaining shares to vest in equal monthly installments (145,833) over the following thirty-six months.
( 2 )1/4 of the option shares vested on September 20, 2019, with the remaining option shares to vest in equal monthly installments over the following thirty-six months. The option provides for an early-exercise provision and is exercisable as to unvested shares, subject to the Issuer's right of repurchase.
( 3 )The shares vest in equal monthly installments over the forty-eight months following February 1, 2020.
( 4 )The shares vest in equal monthly installments over the forty-eight months following July 9, 2019. The option provides for an early-exercise provision and is exercisable as to unvested shares, subject to the Issuer's right of repurchase.
( 5 )The Series A Convertible Preferred Stock is convertible at any time, at the Reporting Person's election, has no expiration date, and will automatically convert to shares of the Issuer's Common Stock immediately prior to the closing of the Issuer's initial public offering on a 1-for-1 basis.
( 6 )The shares of Series A Convertible Preferred Stock are held by Lyell Investors, LLC. The Reporting Person is a manager of Lyell Investors, LLC (Lyell Investors) and may be deemed to share the power to direct the disposition and vote of the shares held by Lyell Investors. The Reporting Person disclaims beneficial ownership of all shares held by Lyell Investors except to any pecuniary interest therein.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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