SEC Filing | Surrozen

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SEC FORM 3 SEC Form 3

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

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1. Name and Address of Reporting Person^*

Li Yang

(Last)

(First)

(Middle)

171 OYSTER POINT BLVD.

SUITE 400

(Street)

SOUTH SAN FRANCISCO

94080

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
08/17/2023

3. Issuer Name and Ticker or Trading Symbol
Surrozen, Inc./DE [ SRZN ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Exec. Vice President, Research

5. 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 Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	121,524	D
Common Stock	10,538	I	See footnote⁽¹⁾

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Option (right to buy)	10/12/2022⁽²⁾	10/03/2032	Common Stock	500	2.03	D
Option (right to buy)	02/01/2022⁽²⁾	03/01/2032	Common Stock	100,000	3.11	D
Option (right to buy)	02/01/2023⁽²⁾	02/01/2033	Common Stock	80,000	0.7001	D
Option (right to buy)	02/01/2021⁽²⁾	02/22/2031	Common Stock	22,835	2.16	D

Explanation of Responses:

1. Held through immediate family members of the Reporting Person. The Reporting Person disclaims beneficial ownership of these shares.

2. 1/48th of the shares subject to the option shall vest on each monthly anniversary of the vesting commencement date over a four-year period.

Remarks:

	/s/Charles Williams, Attorney-in-Fact for Yang Li	08/23/2023
	** 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 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).
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.

POWER OF ATTORNEY

Know all by these presents, that the undersigned hereby constitutes and
appoints each of Craig Parker, Charles Williams, John T. McKenna, Nicolas
L. Francis and Eric Steiner signing individually, the undersigneds true and
lawful attorneys-in fact and agents to:

(1) execute for and on behalf of the undersigned, in the undersigneds
capacity as an officer, director or beneficial owner of more than 10% of a
registered class of securities of Surrozen, Inc. (the Company), Forms 3, 4
and 5 (including any amendments thereto) in accordance with Section 16(a)
of the Securities Exchange Act of 1934, as amended (the Exchange Act) and
the rules thereunder and a Form ID, Uniform Application for Access Codes to
File on EDGAR;

(2) do and perform any and all acts for and on behalf of the undersigned
that may be necessary or desirable to execute such Forms 3, 4 or 5 or Form
ID (including any amendments thereto) and timely file such forms with the
United States Securities and Exchange Commission and any stock exchange or
similar authority; and

(3) take any other action of any nature whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of
benefit, in the best interest of, or legally required by, the undersigned,
it being understood that the documents executed by such attorney- in-fact
on behalf of the undersigned pursuant to this Power of Attorney shall be in
such form and shall contain such terms and conditions as such
attorney-in-fact may approve in such attorney-in- facts discretion.

The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever
requisite, necessary or proper to be done in the exercise of any of the
rights and powers herein granted, as fully to all intents and purposes as
the undersigned might or could do if personally present, with full power of
substitution or revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorney-in-facts substitute or substitutes,
shall lawfully do or cause to be done by virtue of this power of attorney
and the rights and powers herein granted. The undersigned acknowledges that
the foregoing attorneys-in-fact, in serving in such capacity at the request
of the undersigned, are not assuming, nor is the Company assuming, any of
the undersigneds responsibilities to comply with Section 16 of the Exchange
Act.

This Power of Attorney supersedes any power of attorney previously executed
by the undersigned regarding the purposes outlined in the first paragraph
hereof (Prior Powers of Attorney), and the authority of the
attorneys-in-fact named in any Prior Powers of Attorney is hereby revoked.

This Power of Attorney shall remain in full force and effect until the
earliest to occur of (a) the undersigned is no longer required to file
Forms 3, 4 and 5 with respect to the undersigneds holdings of and
transactions in securities issued by the Company, (b) revocation by the
undersigned in a signed writing delivered to the foregoing
attorneys-in-fact or (c) as to any attorney-in-fact individually, until
such attorney- in-fact is no longer employed by the Company or Cooley LLP.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of August 15, 2023.


/s/ Yang Li
Yang Li