Form 4: Translate Bio, Inc. (TBIO), Formela Jean Francois, transaction 12/21/2020
Summary
This Form 4 from Jean-Francois Formela, a director of Translate Bio, Inc. [TBIO], reports sales of common stock by Atlas Venture Associates VIII, L.P. on 12/21/2020 and 12/22/2020. Table I lists 56,536 shares sold at a weighted average price of $25.5046, then 79,865 shares at $25.0421 and 2,700 shares at $25.8825, leaving 43,940 shares, with another 2,656,519 shares owned indirectly through Atlas Venture Fund VIII, L.P. Dr. Formela disclaims Section 16 beneficial ownership except to the extent of any pecuniary interest, and the footnotes state that AVA VIII LP received the shares in a pro-rata stock distribution under a Rule 10b5-1 plan established by Atlas VIII. The form is signed by Ommer Chohan on 12/23/2020.
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“Form 4: Translate Bio, Inc. (TBIO), Formela Jean Francois, transaction 12/21/2020.”
Original at www.sec.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/sec-tbio-4-filed2020-12-23-0001104659-20-139273-4661c3a80d/
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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 | OMB APPROVAL | OMB Number: 3235-0287 Estimated average burden hours per response: 0.5 | 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 * FORMELA JEAN FRANCOIS (Last) (First) (Middle) C/O TRANSLATE BIO, INC. 29 HARTWELL AVENUE (Street) LEXINGTON, MA 02421 (City) (State) (Zip) | FORMELA JEAN FRANCOIS | (Last) | (First) | (Middle) | C/O TRANSLATE BIO, INC. | 29 HARTWELL AVENUE | LEXINGTON, | MA | 02421 | (City) | (State) | (Zip) | 2. Issuer Name and Ticker or Trading Symbol Translate Bio, Inc. [ TBIO ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below) | X | Director | 10% Owner | Officer (give title below) | Other (specify below)
3. Date of Earliest Transaction
(Month/Day/Year) 12/21/2020
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 | 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 (1) | 12/21/2020 | S | 56,536 | D | $ 25.5046 (2) | 126,505 | I | See Footnote (1)
Common Stock (1) | 12/22/2020 | S | 79,865 | D | $ 25.0421 (3) | 46,640 | I | See Footnote (1)
Common Stock (1) | 12/22/2020 | S | 2,700 | D | $ 25.8825 (4) | 43,940 | I | See Footnote (1)
Common Stock | 2,656,519 | I | See Footnote (5)
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
Explanation of Responses:
1. Represents shares sold by Atlas Venture Associates VIII, L.P. ("AVA VIII LP"). The shares were previosly received by AVA VIII LP in a pro-rata stock distribution pursuant to a Rule 10b5-1 plan established by Atlas Venture Fund VIII, L.P. ("Atlas VIII"). Atlas Venture Associates VIII, Inc. ("AVA VIII INC") is the general partner of AVA VIII LP. Dr. Formela is a director of AVA VIII INC and disclaims Section 16 beneficial ownership of the securities held by AVA VIII LP, except to the extent of his pecuniary interest therein, if any. This report shall not be deemed to an admission that Dr. Formela is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
2. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $25.14 - $26.09, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in footnote (2) of this Form 4.
3. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $24.75 - $25.66, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in footnote (3) of this Form 4.
4. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $25.88 - $25.95, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in footnote (4) of this Form 4.
5. These shares are held directly by Atlas VIII. The sole general partner of Atlas VIII is AVA VIII LP. AVA VIII INC is the sole general partner of AVA VIII LP. Dr. Formela is a director of AVA VIII INC and disclaims Section 16 beneficial ownership of the securities held by Atlas VIII, except to the extent of his pecuniary interest therein, if any. This report shall not be deemed to an admission that Dr. Formela is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
By: /s/ Ommer Chohan -Attoreny in Fact | 12/23/2020
** 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.
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