Surrozen, Inc./DE — Director's Dealing 2021

Aug 17, 2021

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: Surrozen, Inc./DE (SRZN)
CIK: 0001824893
Period of Report: 2021-08-11

Reporting Person: COLUMN GROUP III GP, LP (10% Owner)
Reporting Person: COLUMN GROUP III-A, LP (10% Owner)
Reporting Person: COLUMN GROUP III, LP (10% Owner)

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock	4343245	Indirect
Common Stock	4904884	Indirect

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Common Stock Warrant (right to buy)	$11.50		Common Stock (78272)		Indirect
Common Stock Warrant (right to buy)	$11.50		Common Stock (88394)		Indirect

Footnotes

F1: Represents 4,108,427 shares of the Issuer's common stock received in exchange for shares of stock of Surrozen, Inc. ("Original Surrozen") in connection with the merger of Original Surrozen with and into a wholly owned subsidiary of the Issuer (the "Merger") and 234,818 shares of the Issuer's common stock underlying units purchased from the Issuer for $10.00 per unit (a "Unit"), with each unit consisting of one share of the Issuer's common stock and one-third of one redeemable warrant to purchase one share of the Issuer's common stock (the "Warrant").

F2: The securities are directly held by The Column Group III, LP ("TCG III LP"). The Column Group III GP, LP ("TCG III GP") is the general partner of TCG III LP and may be deemed to have voting, investment and dispositive power with respect to these securities. The managing partners of TCG III GP are David Goeddel, Peter Svennilson and Tim Kutzkey, a member of the Issuer's board of directors (collectively, the "Managing Partners"). The Managing Partners may be deemed to share voting and investment power with respect to such securities. TCG III GP and each of the Managing Partners disclaim beneficial ownership of these securities, except to the extent of their respective pecuniary interest in such securities.

F3: Represents 4,639,702 shares of the Issuer's common stock received in connection with the Merger and 265,182 shares of the Issuer's common stock underlying Units purchased from the Issuer.

F4: The securities are directly held by The Column Group III-A, LP ("TCG III-A LP"). TCG III GP is the general partner of TCG III-A LP and may be deemed to have voting, investment and dispositive power with respect to these securities. The managing partners of TCG III GP are the Managing Partners. The Managing Partners may be deemed to share voting and investment power with respect to such securities. TCG III GP and each of the Managing Partners disclaim beneficial ownership of these securities, except to the extent of their respective pecuniary interest in such securities.

F5: Each whole Warrant entitles the holder thereof to purchase one share of the Issuer's common stock at a price of $11.50 per share.