Sec Form 4 Filing - 5AM Partners VI, LLC @ Artiva Biotherapeutics, Inc. - 2024-07-22

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
5AM Partners VI, LLC
2. Issuer Name and Ticker or Trading Symbol
Artiva Biotherapeutics, Inc. [ ARTV]
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)
4 EMBARCADERO CENTER, SUITE 3110,
3. Date of Earliest Transaction (MM/DD/YY)
07/22/2024
(Street)
SAN FRANCISCO, CA94111
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
Common Stock 07/22/2024 C 1,058,284 A 1,058,284 I By 5AM Ventures VI, L.P. ( 2 )
Common Stock 07/22/2024 J( 3 ) 112,966 A $ 10.2 1,171,250 I By 5AM Ventures VI, L.P. ( 2 )
Common Stock 07/22/2024 J( 4 ) 348,721 A $ 10.2 348,721 I By 5AM Opportunities II, L.P. ( 5 )
Common Stock 07/22/2024 P 833,333 A $ 12 1,182,054 I By 5AM Opportunities II, L.P. ( 5 )
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 ) 07/22/2024 C 843,592 ( 1 ) ( 1 ) Common Stock 843,592 ( 1 ) 0 I By 5AM Ventures VI, L.P. ( 2 )
Series B Preferred Stock ( 1 ) 07/22/2024 C 214,692 ( 1 ) ( 1 ) Common Stock 214,692 ( 1 ) 0 I By 5AM Ventures VI, L.P. ( 2 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
5AM Partners VI, LLC
4 EMBARCADERO CENTER, SUITE 3110
SAN FRANCISCO, CA94111
X
5AM Ventures VI, L.P.
4 EMBARCADERO CENTER, SUITE 3110
SAN FRANCISCO, CA94111
X
5AM Opportunities II (GP), LLC
4 EMBARCADERO CENTER, SUITE 3110
SAN FRANCISCO, CA94111
X
5AM Opportunities II, L.P.
4 EMBARCADERO CENTER, SUITE 3110
SAN FRANCISCO, CA94111
X
PARMAR KUSH
C/O 5AM VENTURE MANAGEMENT, LLC
4 EMBARCADERO CENTER, SUITE 3110
SAN FRANCISCO, CA94111
X
Schwab Andrew J.
C/O 5AM VENTURE MANAGEMENT, LLC
4 EMBARCADERO CENTER, SUITE 3110
SAN FRANCISCO, CA94111
X
Signatures
5AM Partners VI, LLC, By /s/ Kush Parmar, Managing Member 07/24/2024
Signature of Reporting Person Date
5AM Ventures VI, L.P., By: 5AM Partners VI, LLC, its General Partner, By /s/ Kush Parmar, Managing Member 07/24/2024
Signature of Reporting Person Date
5AM Opportunities II (GP), LLC, By /s/ Kush Parmar, Managing Member 07/24/2024
Signature of Reporting Person Date
5AM Opportunities II, L.P., By: 5AM Opportunities II (GP), LLC, its General Partner, By /s/ Kush Parmar, Managing Member 07/24/2024
Signature of Reporting Person Date
/s/ Kush Parmar 07/24/2024
Signature of Reporting Person Date
/s/ Andrew J. Schwab 07/24/2024
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Each share of Series A Preferred Stock and Series B Preferred Stock (collectively, the "Preferred Stock") converted into shares of Common Stock of the Issuer on a one-for-one basis without payment of further consideration. Upon the closing of the Issuer's initial public offering (the "IPO"), the Preferred Stock wasconverted into the number of shares of Common Stock of the Issuer shown in column 7 of Table II. The Preferred Stock had no expiration date.
( 2 )The shares are directly held by 5AM Ventures VI, L.P. ("Ventures VI"). 5AM Partners VI, LLC ("Partners VI") is the sole general partner of Ventures VI. Dr. Kush Parmar and Andrew J. Schwab are the managing members of Partners VI and may be deemed to have shared voting and investment power over the shares beneficially owned by Ventures VI. Each of Partners VI, Dr. Parmar, and Mr. Schwab disclaims beneficial ownership of such shares except to the extent of its or his respective pecuniary interest therein.
( 3 )Represents the conversion of outstanding simple agreement for future equity in the amount of $1,152,253.93 into shares of the Issuer's common stock upon closing of the Issuer's IPO at a 15% discount to the IPO price.
( 4 )Represents the conversion of outstanding simple agreement for future equity in the amount of $3,556,957.78 into shares of the Issuer's common stock upon closing of the Issuer's IPO at a 15% discount to the IPO price.
( 5 )Shares are held by 5AM Opportunities II, L.P. ("Opportunities II"). 5AM Opportunities II (GP), LLC ("Opportunities II GP") is the general partner of Opportunities II and may be deemed to have sole investment and voting power over the shares held by Opportunities II. Dr. Kush Parmar and Andrew J. Schwab are the managing members of Opportunities II GP and may be deemed to have shared voting and investment power over the shares beneficially owned by Opportunities II. Each of Opportunities II GP, Dr. Parmar and Mr. Schwab disclaims beneficial ownership of such shares except to the extent of its or his respective pecuniary interest therein.

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