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*
INTERWEST PARTNERS X LP

(Last) (First) (Middle)
467 FIRST STREET, SUITE 201

(Street)
LOS ALTOS CA 94022

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/24/2020
3. Issuer Name and Ticker or Trading Symbol
PMV Pharmaceuticals, Inc. [ PMVP ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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)
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
Series Seed Preferred Stock (1) (1) Common Stock 1,620,101 0.00 D(2)
Series A Preferred Stock (1) (1) Common Stock 3,488,398 0.00 D(2)
Series B Preferred Stock (1) (1) Common Stock 1,040,654 0.00 D(2)
Series C Preferred Stock (1) (1) Common Stock 265,203 0.00 D(2)
1. Name and Address of Reporting Person*
INTERWEST PARTNERS X LP

(Last) (First) (Middle)
467 FIRST STREET, SUITE 201

(Street)
LOS ALTOS CA 94022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
InterWest Management Partners X, LLC

(Last) (First) (Middle)
467 FIRST STREET, SUITE 201

(Street)
LOS ALTOS CA 94022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
NASR KHALED

(Last) (First) (Middle)
467 FIRST STREET, SUITE 201

(Street)
LOS ALTOS CA 94022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Desai Keval

(Last) (First) (Middle)
467 FIRST STREET, SUITE 201

(Street)
LOS ALTOS CA 94022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Kliman Gilbert H

(Last) (First) (Middle)
467 FIRST STREET, SUITE 201

(Street)
LOS ALTOS CA 94022

(City) (State) (Zip)
Explanation of Responses:
1. The shares of each of the Series Seed Preferred Stock, Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock shall automatically convert into shares of Common Stock on a one to one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and have no expiration date.
2. The securities are directly held by InterWest Partners X, LP ("IW10"). InterWest Management Partners X, LLC ("IMP10"), as the general partner of IW10, may be deemed to beneficially own the shares held by IW10. Arnold L. Oronsky and Gilbert H. Kliman are Managing Directors of IMP10, and Khaled A. Nasr and Keal Desai are Venture Members of IMP10. Each of the foregoing persons may be deemed to beneficially own the shares held by IW10, and each foregoing person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
Remarks:
Arnold L. Oronsky, a Managing Director of IMP X, is also a Director of the Issuer and has filed a separate Form 3 in his own name.
/s/ Karen Wilson, Attorney-in-Fact for InterWest Partners X, LP 09/24/2020
/s/ Karen Wilson, Attorney-in-Fact for InterWest Management Partners X, LLC 09/24/2020
/s/ Karen Wilson, Attorney-in-Fact for Khaled A. Nasr 09/24/2020
/s/ Karen Wilson, Attorney-in-Fact for Keval Desai 09/24/2020
/s/ Karen Wilson, Attorney-in-Fact for Gilbert H. Kliman 09/24/2020
** 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).
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