Sec Form 3 Filing - Founders Fund V, LP @ Applied Molecular Transport Inc. - 2020-06-04

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
Founders Fund V, LP
2. Issuer Name and Ticker or Trading Symbol
Applied Molecular Transport Inc. [ AMTI]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O FOUNDERS FUND, ONE LETTERMAN DRIVE, BLDG. D, SUITE 500
3. Date of Earliest Transaction (MM/DD/YY)
06/04/2020
(Street)
SAN FRANCISCO, CA94129
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ 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
Series A Preferred Stock ( 1 ) ( 1 ) ( 1 ) Common Stock 3,619,429 I See Footnotes ( 2 ) ( 5 )
Series B Preferred Stock ( 1 ) ( 1 ) ( 1 ) Common Stock 257,400 I See Footnotes ( 3 ) ( 5 )
Series C Preferred Stock ( 1 ) ( 1 ) ( 1 ) Common Stock 574,052 I See Footnotes ( 4 ) ( 5 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Founders Fund V, LP
C/O FOUNDERS FUND
ONE LETTERMAN DRIVE, BLDG. D, SUITE 500
SAN FRANCISCO, CA94129
X
Founders Fund V Entrepreneurs Fund, LP
C/O FOUNDERS FUND
ONE LETTERMAN DRIVE, BLDG. D, SUITE 500
SAN FRANCISCO, CA94129
X
Founders Fund V Principals Fund, LP
C/O FOUNDERS FUND
ONE LETTERMAN DRIVE, BLDG. D, SUITE 500
SAN FRANCISCO, CA94129
X
Founders Fund VI, LP
C/O FOUNDERS FUND
ONE LETTERMAN DRIVE, BLDG. D, SUITE 500
SAN FRANCISCO, CA94129
X
Founders Fund VI Entrepreneurs Fund, LP
C/O FOUNDERS FUND
ONE LETTERMAN DRIVE, BLDG. D, SUITE 500
SAN FRANCISCO, CA94129
X
Founders Fund VI Principals Fund, LP
C/O FOUNDERS FUND
ONE LETTERMAN DRIVE, BLDG. D, SUITE 500
SAN FRANCISCO, CA94129
X
Signatures
/s/Brian Singerman, Partner of The Founders Fund Management V LLC, General Partner of The Founders Fund V, LP 06/04/2020
Signature of Reporting Person Date
/s/ Brian Singerman, Partner of The Founders Fund Management V, LLC, General Partner of The Founders Fund V Entrepreneurs Fund, LP 06/04/2020
Signature of Reporting Person Date
/s/ Brian Singerman, Partner of The Founders Fund Management V, LLC, General Partner of The Founders Fund V Principals Fund, LP 06/04/2020
Signature of Reporting Person Date
/s/ Brian Singerman, Partner of The Founders Fund Management VI, LLC, General Partner of The Founders Fund VI, LP 06/04/2020
Signature of Reporting Person Date
/s/ Brian Singerman, Partner of The Founders Fund Management VI, LLC, General Partner of The Founders Fund VI Entrepreneurs Fund, LP 06/04/2020
Signature of Reporting Person Date
/s/ Brian Singerman, Partner of The Founders Fund Management VI, LLC, General Partner of The Founders Fund VI Principals Fund, LP 06/04/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Each share of the issuer's Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock will automatically convert into one share of common stock immediately prior to the completion of the issuer's initial public offering and has no expiration date.
( 2 )2,814,640 of these shares are owned directly by The Founders Fund V, LP, 757,139 of these shares are held by The Founders Fund V Principals Fund, LP, and 39,836 of these shares are owned directly by The Founders Fund V Entrepreneurs Fund, LP.
( 3 )202,311 of these shares are owned directly by The Founders Fund VI, LP, 50,025 of these shares are owned directly by The Founders Fund VI Principals Fund, LP and 2,515 of these shares are owned directly by The Founders Fund VI Entrepreneurs Fund, LP.
( 4 )453,883 of these shares are owned directly by The Founders Fund VI LP, 112,230 of these shares are owned directly by The Founders Fund VI Principals Fund, LP, and 5,643 of these shares are owned directly by The Founders Fund VI Entrepreneurs Fund, LP.
( 5 )The Founders Fund V Management LLC is the general partner of each of The Founders Fund V, LP, The Founders Fund V Entrepreneurs Fund, LP and The Founders Fund V Principals Fund, LP (the FFV Funds) and exercises investment and voting control over the shares held by the FFV Funds through a management committee comprised of Peter Thiel and Brian Singerman. The Founders Fund VI Management LLC is the general partner of each of The Founders Fund VI, LP, The Founders Fund VI Entrepreneurs Fund, LP and The Founders Fund VI Principals Fund, LP (the FFVI Funds) and exercises investment and voting control over the shares held by the FFVI Funds through a management committee comprised of Peter Thiel and Brian Singerman. Each of Messrs. Thiel and Singerman disclaim beneficial ownership of the shares held by the FFV Funds and the FFVI Funds, except to the extent of their pecuniary interest therein, if any.

Remarks:
* Date set forth above represents the effective date of issuer's initial public offering.

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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