SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Andersson Claus A.

(Last) (First) (Middle)
C/O IO BIOTECH, INC.
OLE MAALOES VEH 3

(Street)
COPENHAGEN G7 2200

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
IO Biotech, Inc. [ IOBT ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
11/09/2021
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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 11/09/2021 C 1,361,660 A (1) 1,361,660 I See footnote(3)
Common Stock 11/09/2021 C 354,830 A (2) 1,716,490 I See footnote(3)
Common Stock 11/09/2021 P 75,000 A $14 1,791,490 I See footnote(3)
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: 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 (1) 11/09/2021 C 147,881 (1) (1) Common Stock 1,361,660 $0 0 I See footnote(3)
Series C Preferred Stock (2) 11/09/2021 C 28,225 (2) (2) Common Stock 354,830 $0 0 I See footnote(3)
Explanation of Responses:
1. Upon the closing of the Issuer's initial public offering ("IPO"), each share of Series B Preferred Stock beneficially owned by the reporting person automatically converted, for no additional consideration, into the number of shares of Common Stock reported in Column 7 of Table II. These shares of Series B Preferred Stock had no expiration date.
2. Upon the closing of the IPO, each share of Series C Preferred Stock beneficially owned by the reporting person automatically converted, for no additional consideration, into the number of shares of Common Stock reported in Column 7 of Table II. These shares of Series C Preferred Stock had no expiration date.
3. Sunstone Life Science Ventures Fund III K/S ("Sunstone Fund III"). Sunstone LSV General Partner III ApS ("Sunstone LSV GP III") is the general partner of Sunstone Fund III and has voting and dispositive power over all of the shares of held by Sunstone Fund III. The reporting person is a General Partner of Sunstone Life Science Ventures A/S and a member of the executive board of Sunstone LSV GP III, and shares voting and dispositive power with respect to the shares held by Sunstone Fund III. The reporting person disclaims beneficial ownership of the shares held directly by Sunstone Fund III except to the extent of his pecuniary interest therein.
/s/ Brian Burkavage, Attorney-in-Fact for Claus Andersson 11/12/2021
** 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 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).
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.