Sec Form 4 Filing - Schroeder Thilo @ Silverback Therapeutics, Inc. - 2020-12-08

Insider filing report for Changes in Beneficial Ownership
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FORM 4
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
Schroeder Thilo
2. Issuer Name and Ticker or Trading Symbol
Silverback Therapeutics, Inc. [ SBTX]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O SILVERBACK THERAPEUTICS, INC., 500 FAIRVIEW AVENUE N, SUITE 600
3. Date of Earliest Transaction (MM/DD/YY)
12/08/2020
(Street)
SEATTLE, WA98109
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 12/08/2020 P( 1 ) 238,096 A $ 21 238,096 I By Nextech VI Oncology SCSp ( 2 )
Common Stock 12/08/2020 C 1,246,870 ( 3 ) A 1,484,966 I By Nextech VI Oncology SCSp ( 2 )
Common Stock 12/08/2020 C 425,063 ( 3 ) A 1,910,029 I By Nextech VI Oncology SCSp ( 2 )
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
Series B Preferred Stock ( 3 ) 12/08/2020 C 4,629,630 ( 3 ) ( 3 ) Common Stock 1,246,870 $ 0 0 I By Nextech VI Oncology SCSp ( 2 )
Series C Preferred Stock ( 3 ) 12/08/2020 C 1,578,259 ( 3 ) ( 3 ) Common Stock 425,063 $ 0 0 I By Nextech VI Oncology SCSp ( 2 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Schroeder Thilo
C/O SILVERBACK THERAPEUTICS, INC.
500 FAIRVIEW AVENUE N, SUITE 600
SEATTLE, WA98109
X
Signatures
/s/ Jeffrey C. Pepe, Attorney-in-Fact 12/08/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The shares were purchased in the Issuer's initial public offering.
( 2 )Nextech Invest AG is the investment advisor of Nextech VI Oncology SCSp ("Nextech VI"). The reporting person is a managing member at Nextech Invest AG and may therefore be deemed to be the beneficial owner of shares held by Nextech VI. The reporting person disclaims beneficial ownership of such shares, except to the extent of any pecuniary interest therein.
( 3 )All outstanding shares of Preferred Stock automatically converted into shares of Common Stock immediately upon the closing of the Issuer's initial public offering, for no additional consideration at a rate of one share of Common Stock for each 3.713 shares of Preferred Stock, based on the conversion price currently in effect. The Preferred Stock has no expiration 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 4(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).

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