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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
C/O THIRD ROCK VENTURES, LLC, |
29 NEWBURY STREET, 3RD FLOOR |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/02/2016
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3. Issuer Name and Ticker or Trading Symbol
Editas Medicine, Inc.
[ EDIT ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series A-1 Preferred Stock |
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Common Stock |
2,549,437 |
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D
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Series A-2 Preferred Stock |
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Common Stock |
2,021,269 |
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D
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Series B Preferred Stock |
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Common Stock |
85,470 |
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D
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1. Name and Address of Reporting Person*
C/O THIRD ROCK VENTURES, LLC, |
29 NEWBURY STREET, 3RD FLOOR |
(Street)
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1. Name and Address of Reporting Person*
29 NEWBURY STREET, 3RD FLOOR |
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(Street)
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1. Name and Address of Reporting Person*
29 NEWBURY STREET, 3RD FLOOR |
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(Street)
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1. Name and Address of Reporting Person*
C/O THIRD ROCK VENTURES, LLC |
29 NEWBURY STREET, 3RD FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O THIRD ROCK VENTURES, LLC |
29 NEWBURY STREET, 3RD FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O THIRD ROCK VENTURES, LLC |
29 NEWBURY STREET, 3RD FLOOR |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Kevin Gillis, Chief Financial Officer of TRV GP III, LLC, general partner of Third Rock Ventures GP III, L.P., general partner of Third Rock Ventures III, L.P. |
02/02/2016 |
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/s/ Kevin Gillis, Chief Financial Officer of TRV GP III, LLC, general partner of Third Rock Ventures GP III, L.P. |
02/02/2016 |
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/s/ Kevin Gillis, Chief Financial Officer of TRV GP III, LLC |
02/02/2016 |
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/s/ Kevin Gillis by power of attorney for Mark Levin |
02/02/2016 |
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/s/ Kevin Gillis by power of attorney for Kevin Starr |
02/02/2016 |
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/s/ Kevin Gillis by power of attorney for Dr. Robert Tepper |
02/02/2016 |
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** 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. |
EXHIBIT 24
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby
constitutes and appoints Kevin Gillis his true and lawful attorney-in-fact, with
full power of substitution, to sign any and all instruments, certificates and
documents that may be necessary, desirable or appropriate to be executed on
behalf of himself as an individual or in his capacity as a direct or indirect
general partner, director, officer, member or manager of any partnership,
corporation or limited liability company, pursuant to section 13 or 16 of the
Securities Exchange Act of 1934, as amended (the "Exchange Act"), and any and
all regulations promulgated thereunder, and to file the same, with all exhibits
thereto, and any other documents in connection therewith, with the Securities
and Exchange Commission, and with any other entity when and if such is mandated
by the Exchange Act or by the Financial Industry Regulatory Authority, granting
unto said attorney-in-fact full power and authority to do and perform each and
every act and thing necessary, desirable or appropriate, fully to all intents
and purposes as he might or could do in person, thereby ratifying and confirming
all that said attorney-in-fact, or his substitutes, may lawfully do or cause to
be done by virtue hereof. Each of the undersigned may execute this power of
attorney in separate counterparts, and each counterpart shall be deemed to be an
original instrument. This agreement shall be effective as to each of the
undersigned as of the date signed by that signatory.
IN WITNESS WHEREOF, this Power of Attorney has been signed as of the 16th day of
January, 2014.
/s/ Mark Levin
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Mark Levin
/s/ Kevin P. Starr
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Kevin P. Starr
/s/ Robert I. Tepper
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Robert I. Tepper
EXHIBIT 99
FORM 3 JOINT FILER INFORMATION
Names of Joint Filers:
Third Rock Ventures III, L.P.
Third Rock Ventures GP III, L.P.
TRV GP III, LLC
Mark Levin
Kevin Starr
Dr. Robert Tepper
Address of Joint Filers:
C/O Third Rock Ventures, LLC
29 Newbury Street, 3rd Floor
Boston, MA 02116
Designated Filer:
Third Rock Ventures III, L.P.
Issuer and Ticker Symbol:
Editas Medicines, Inc. [EDIT]
Date of Event:
February 2, 2016
Signatures of Joint Filers:
THIRD ROCK VENTURES III, L.P.
By: THIRD ROCK VENTURES GP III, L.P.,
General Partner
By: TRV GP III, LLC,
General Partner
By: /s/ Kevin Gillis
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Kevin Gillis
Chief Financial Officer
THIRD ROCK VENTURES GP III, L.P.
By: TRV GP III, LLC,
General Partner
By: /s/ Kevin Gillis
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Kevin Gillis
Chief Financial Officer
TRV GP III, LLC
By: /s/ Kevin Gillis
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Kevin Gillis
Chief Financial Officer
MARK LEVIN
/s/ Kevin Gillis, As attorney-in-fact
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Mark Levin
KEVIN P. STARR
/s/ Kevin Gillis, As attorney-in-fact
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Kevin Starr
ROBERT I. TEPPER
/s/ Kevin Gillis, As attorney-in-fact
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Dr. Robert Tepper