Ownership Submission
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FORM 4
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Check this box if no longer subject to Section 16, Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549STATEMENT OF CHANGES IN 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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OMB APPROVAL
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OMB Number:3235-0287Expires:January 31, 2005Estimated average burden hours per response...0.5
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1. Name and Address of Reporting Person *
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Bender Jeremy
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2. Issuer Name and Ticker or Trading Symbol
Day One Biopharmaceuticals, Inc. [DAWN]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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_____ Director
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_____ 10% Owner
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_____ Officer (give title below)
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_____ Other (specify below)
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CHIEF EXECUTIVE OFFICER /
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(Last)
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(First)
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(Middle)
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2000 SIERRA POINT PARKWAY, SUITE 501
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3. Date of Earliest Transaction (Month/Day/Year)
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(Street)
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BRISBANE
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CA
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94005
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4. If Amendment, Date Original Filed(Month/Day/Year)
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6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
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2. Transaction Date (Month/Day/Year)
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2A. Deemed Execution Date, if any (Month/Day/Year)
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3. Transaction Code
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4. Securities Acquired (A) or Disposed of (D)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
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6. Ownership Form: Direct (D) or Indirect (I)
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7. Nature of Indirect Beneficial Ownership
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
(e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date (Month/Day/Year)
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3A. Deemed Execution Date, if any (Month/Day/Year)
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4. Transaction Code
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
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8. Price of Derivative Security
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
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11. Nature of Indirect Beneficial Ownership
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expriation Date
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Title
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Amount or Number of Shares
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Bender Jeremy
2000 SIERRA POINT PARKWAY, SUITE 501
BRISBANE, CA94005
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CHIEF EXECUTIVE OFFICER
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Signatures
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/s/ Charles N. York II, Attorney-in-Fact
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2024-07-05
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**Signature of Reporting Person
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Date
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Explanation of Responses:
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(*)
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If the form is filed by more than one reporting person, see Instruction 5(b)(v).
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(**)
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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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(1)
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Represents an annuity payment made by The Jeremy Bender 2022 Grantor Retained Annuity Trust under Irrevocable Trust Agreement dated March 29, 2022 ("Jeremy Bender 2022 GRAT"), which was transferred by the Reporting Person as a bona fide gift for no consideration to the Bender Revocable Trust dated January 18, 2017, as amended, Jeremy Bender and Melissa C. Bender, Trustees ("Bender Revocable Trust dated January 18, 2017").
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(2)
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Represents shares held by the Jeremy Bender 2022 GRAT of which the Reporting Person is trustee.
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(3)
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Includes 565,114 shares of the Issuer's Common Stock that the Reporting Person retitled on July 2, 2024.
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(4)
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Represents shares held by the Bender Revocable Trust dated January 18, 2017.
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(5)
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Represents an annuity payment made by The Melissa Bender 2022 Grantor Retained Annuity Trust under Irrevocable Trust Agreement dated March 29, 2022 ("Melissa Bender 2022 GRAT"), which was transferred by the Reporting Person as a bona fide gift for no consideration to the Bender Revocable Trust dated January 18, 2017.
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(6)
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Represents shares held by the Melissa Bender 2022 GRAT of which the Reporting Person's spouse is trustee.
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(7)
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Represents an annuity payment made by The Jeremy Bender 2023 Grantor Retained Annuity Trust dated June 27, 2023 ("Jeremy Bender 2023 GRAT"), which was transferred by the Reporting Person as a bona fide gift for no consideration to the Bender Revocable Trust dated January 18, 2017.
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(8)
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Represents shares held by the Jeremy Bender 2023 GRAT.
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(9)
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Represents an annuity payment made by The Melissa Bender 2023 Grantor Retained Annuity Trust, dated June 27, 2023 ("Melissa Bender 2023 GRAT"), which was transferred by the Reporting Person as a bona fide gift for no consideration to the Bender Revocable Trust dated January 18, 2017.
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(10)
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Represents shares held by the Melissa Bender 2023 GRAT.
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Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
Day One Biopharmaceuticals Inc.