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Translate Bio (TBIO)

Filed: 27 Jun 18, 6:31pm
SEC Form 3
FORM 3UNITED 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*
Renaud Ronald C JR

(Last)(First)(Middle)
C/O TRANSLATE BIO, INC.
29 HARTWELL AVENUE

(Street)
LEXINGTONMA02421

(City)(State)(Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/27/2018
3. Issuer Name and Ticker or Trading Symbol
Translate Bio, Inc. [ TBIO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
XDirectorX10% Owner
XOfficer (give title below)Other (specify below)
See Remarks
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
XForm 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 Stock369,003IBy Ronald Renaud 2014 Irrevocable Family Trust
Common Stock435,559D
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 Security5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date ExercisableExpiration DateTitleAmount or Number of Shares
Series C Preferred Stock(1)(1)Common Stock40,909(1)IBy Ronald Renaud 2014 Irrevocable Family Trust
Series C Preferred Stock(1)(1)Common Stock40,909(1)IBy The Ronald C. Renaud, Jr. Trust - 2007
Stock Option (right to buy)(2)12/21/2027Common Stock1,138,6777.39D
Stock Option (right to buy)(3)03/06/2028Common Stock90,0008.34D
Explanation of Responses:
1. The Series C Preferred Stock is convertible into Common Stock on a 5.5555-for-one basis into the number of shares of Common Stock shown in Colum 3 at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering. The shares have no expiration date.
2. This option was granted on December 22, 2017. The shares underlying the option are scheduled to vest over four years in equal monthly installments through March 9, 2021.
3. This option was granted on March 7, 2018. The shares underlying the option are scheduled to vest over four years, with 25% of the shares vesting on March 7, 2019 and the remainder vesting in equal monthly installments through March 7, 2022.
Remarks:
President and Chief Executive Officer Exhibit Index: 24.1 Power of Attorney
/s/ Paul Burgess, as attorney-in-fact for Ronald C. Renaud, Jr.06/27/2018
** Signature of Reporting PersonDate
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.