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*
Nemec Sarah

(Last) (First) (Middle)
900 CHESAPEAKE DRIVE

(Street)
REDWOOD CITY CA 94063

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/15/2024
3. Issuer Name and Ticker or Trading Symbol
Bolt Biotherapeutics, Inc. [ BOLT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Principal Accounting Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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 11,363 D
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
Stock Option (Right to Buy) (1) 09/02/2030 Common Stock 26,221 4.34 D
Stock Option (Right to Buy) (2) 02/03/2031 Common Stock 7,500 20 D
Stock Option (Right to Buy) (3) 12/21/2031 Common Stock 12,000 4.51 D
Restricted Stock Unit (RSU) (4) 12/21/2031 Common Stock 8,000 (5) D
Stock Option (Right to Buy) (6) 02/17/2032 Common Stock 44,000 3.08 D
Stock Option (Right to Buy) (7) 01/18/2033 Common Stock 134,000 1.39 D
Stock Option (Right to Buy) (8) 03/03/2034 Common Stock 31,800 1.27 D
Explanation of Responses:
1. 1/4th of the shares subject to the option shall vest on the one year anniversary of August 31, 2020 (the "Vesting Commencement Date"), and 1/48th of the shares shall vest each month thereafter on the same day of the month as the Vesting Commencement Date, subject to the Reporting Person continuing to be a service provider through each such date.
2. For so long as the Reporting Person continuously provides services to the Issuer this option will vest with respect to the shares as follows: 1/48th of the Shares will vest upon the Reporting Person completing each month of continuous service following February 4, 2021.
3. For so long as the Reporting Person continuously provides services to the Issuer this option will vest with respect to the shares as follows: 1/36th of the Shares will vest upon the Reporting Person completing each month of continuous service following December 22, 2021.
4. For so long as the Reporting Person continuously provides services to the Issuer this option will vest with respect to the shares as follows: 1/12th of the Shares will vest upon the Reporting Person completing each 3 months of continuous service following December 10, 2021.
5. Each RSU represents a contingent right to receive one (1) share of the Issuer's Common Stock upon settlement.
6. For so long as the Reporting Person continuously provides services to the Issuer this option will vest with respect to the shares as follows: 1/36th of the Shares will vest upon the Reporting Person completing each month of continuous service following January 1, 2022.
7. For so long as the Reporting Person continuously provides services to the Issuer this option will vest with respect to the shares as follows: 1/36th of the Shares will vest upon the Reporting Person completing each month of continuous service following January 1, 2023.
8. For so long as the Reporting Person continuously provides services to the Issuer this option will vest with respect to the shares as follows: 1/36th of the Shares will vest upon the Reporting Person completing each month of continuous service following January 1, 2024.
/s/ Sarah Nemec 05/15/2024
** 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).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.
EX-24.1

Exhibit 24

POWER OF ATTORNEY

Know all by these presents that the undersigned hereby constitutes and appoints each of William Quinn of Bolt Biotherapeutics, Inc. (the “Company”) and John McKenna, Jaleel Chandler, Ryan Fitzgerald and Brian Woodard of Cooley LLP, signing individually, the undersigned’s true and lawful attorneys-in fact and agents to:

(1) prepare, execute in the undersigned’s name and on the undersigned’s behalf, and submit to the Securities and Exchange Commission (the “SEC”) a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation thereunder;

 

(2) prepare, execute in the undersigned’s name and on the undersigned’s behalf, and submit to the SEC Forms 3, 4 and 5 (including amendments thereto and joint filing agreements in connection therewith) in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;

 

(3) do and perform any and all acts for and on behalf of the undersigned that may be necessary or desirable to prepare and execute any such Form 3, 4 or 5 (including amendments thereto and joint filing agreements in connection therewith) and file such Forms with the SEC and any stock exchange, self-regulatory association or any other authority; and

 

(4) take any other action of any type whatsoever in connection with the foregoing that, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required of the undersigned, it being understood that the documents executed by the attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as the attorney-in-fact may approve in the attorney-in-fact’s discretion.

 

The undersigned hereby grants to each such attorney‑in‑fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney‑in‑fact, or such attorney‑in‑fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, and their substitutes, in serving in such capacity at the request of the undersigned, are not assuming (nor is the Company assuming) any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.

 

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the Company and the attorneys-in-fact.

 

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of the date written below.

 

Dated: _5/14/2024____________

 

 

By: /s/ Sarah Nemec Sarah Nemec

Signature Printed Name