08/06/2026 | Press release | Distributed by Public on 08/06/2026 18:32
|
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 |
|
|
||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
| 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 control number. | |||
|
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 of Derivative Security: 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 Angel Preferred Stock | (1) | (1) | Common Stock | 1,600,682 | (1) | I | By The Li and Cui Family Trust(2) |
| Series B Preferred Stock | (1) | (1) | Common Stock | 124,779 | (1) | I | By RongShan, LLC(3) |
| Series B Preferred Stock | (1) | (1) | Common Stock | 113,435 | (1) | I | By The Li and Cui Family Trust(2) |
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
|
Li Yishan C/O BLOSSOMHILL THERAPEUTICS, INC. 10255 SCIENCE CENTER DRIVE, SUITE 200 SAN DIEGO, CA 92121-1180 |
X | X | Executive Chairman | |
| /s/ Vincent Liptak, Attorney-in-Fact | 08/06/2026 | |
| **Signature of Reporting Person | Date |
| * | 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). |
| (1) | Each share of Series Angel Preferred Stock and Series B Preferred Stock (together, the "Preferred Stock") is convertible into 1 share of Common Stock upon the closing of the Issuer's initial public offering without payment of further consideration. The Preferred Stock has no expiration date. |
| (2) | The shares are held in trust for the benefit of the Reporting Person and his spouse. The Reporting Person and his spouse are trustees of The Li and Cui Family Trust (the "Trust") and have voting and dispositive power over the securities held by the Trust. |
| (3) | The Reporting Person is manager of RongShan, LLC and may be deemed to have voting and dispositive power over the securities held by RongShan.LLC. The Reporting Person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. |