Sec Form 3 Filing - Cook Joseph C. III @ CASTLE BIOSCIENCES INC - 2019-07-24

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
Cook Joseph C. III
2. Issuer Name and Ticker or Trading Symbol
CASTLE BIOSCIENCES INC [ CSTL]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O CASTLE BIOSCIENCES, INC., 820 S. FRIENDSWOOD DRIVE, SUITE 201
3. Date of Earliest Transaction (MM/DD/YY)
07/24/2019
(Street)
FRIENDSWOOD, TX77546
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
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
Stock option (right to buy) $ 16 ( 1 ) 07/23/2029 Common Stock 30,895 D
Series A Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 16,015 I By L.P. ( 3 )
Series B Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 100,210 D
Series D Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 13,058 D
Series D Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 277,074 I By L.P. ( 3 )
Series E-1 Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 380,190 I By L.P. ( 3 )
Series E-2 Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 4,479 D
Series E-2 Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 129,925 I By L.P. ( 3 )
Series E-3 Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 3,840 D
Series E-3 Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 117,180 I By L.P. ( 3 )
Series F Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 47,495 D
Series F Preferred Stock ( 2 ) ( 2 ) ( 2 ) Common Stock 416,537 I By L.P. ( 3 )
Convertible Promissory Note ( 4 ) ( 4 ) ( 4 ) Common Stock $ 205,970.51 ( 4 ) D
Convertible Promissory Note ( 5 ) ( 5 ) ( 5 ) Common Stock $ 1,200,000 ( 5 ) I By L.P. ( 3 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Cook Joseph C. III
C/O CASTLE BIOSCIENCES, INC.
820 S. FRIENDSWOOD DRIVE, SUITE 201
FRIENDSWOOD, TX77546
X X
Signatures
/s/ Greg Acosta, Attorney-in-fact 07/24/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )25% of the shares shall vest on August 1, 2020, and the remaining shares shall vest in 36 equal monthly installments thereafter.
( 2 )All outstanding shares of Preferred Stock will automatically convert into shares of Common Stock immediately upon the closing of the Issuer's initial public offering (the "IPO"), for no additional consideration at a rate of 1 share of Common Stock for each 1.219 shares of Preferred Stock,based on the conversion price currently in effect. The Preferred Stock has no expiration date.
( 3 )Held by MGC Venture Partners 2013, L.P. (the "L.P."). MGC Venture Partners 2013 GP, LLC (the "LLC") is the general partner of the L.P. The Reporting Person is a managing director of the LLC and shares voting and investment power over the shares held by the L.P.
( 4 )The principal amount of the Convertible Promissory Note held by the designated Reporting Person is $205,970.51. Upon closing of the IPO, all unpaid principal and accrued interest outstanding on the Convertible Promissory Note (the "Conversion Amount") will automatically convert into the number of shares of Common Stock that is equal to the Conversion Amount as of the closing date divided by 80% of the IPO price per share.
( 5 )The principal amount of the Convertible Promissory Note held by the L.P. is $1,200,000.00. Upon closing of the IPO, the Conversion Amount will automatically convert into the number of shares of Common Stock that is equal to the Conversion Amount as of the closing date divided by 80% of the IPO price per share.

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