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*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 08/01/2017 | 3. Issuer Name and Ticker or Trading Symbol Molecular Templates, Inc. [ MTEM ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 | 2,922,993 | D(1) |
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) | 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) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. These shares are owned directly by Millennium Pharmaceuticals, Inc. ("Millennium"). Millennium is a wholly-owned direct subsidiary of Takeda Pharmaceuticals U.S.A., Inc. ("Takeda USA"). Takeda Pharmaceutical Company Limited ("Takeda") owns 73.37% of Takeda USA, and Takeda Pharmaceuticals International AG ("Takeda International") owns 26.63% of Takeda USA. Takeda Pharma A/S ("Takeda Denmark") owns 86.83% of Takeda International, and Takeda Europe Holdings B.V. ("Takeda Europe") owns 13.17% of Takeda International. Takeda Denmark is a wholly-owned direct subsidiary of Takeda A/S. Takeda owns 76.09% of Takeda A/S, and Takeda Europe owns 23.91% of Takeda A/S. Takeda Europe is a wholly-owned direct subsidiary of Takeda. Takeda, Takeda USA, Takeda International, Takeda Denmark, Takeda A/S and Takeda Europe each disclaims beneficial ownership of such shares except to the extent of its pecuniary interest therein. |
Remarks: |
Exhibit List: Exhibit 24.1 Power of Attorney for Millennium Pharmaceuticals, Inc.; Exhibit 24.2 Power of Attorney for Takeda Pharmaceuticals U.S.A., Inc.; Exhibit 24.3 Power of Attorney for Takeda Pharmaceuticals International AG; Exhibit 24.4 Power of Attorney for Takeda Pharma A/S; Exhibit 24.5 Power of Attorney for Takeda A/S; Exhibit 24.6 Power of Attorney for Takeda Europe Holdings B.V. |
/s/ James Kehoe, Chief Financial Officer, Takeda Pharmaceutical Company Limited | 09/08/2017 | |
/s/ Brett R. Budzinski, Attorney-in-Fact for Millennium Pharmaceuticals, Inc. | 09/08/2017 | |
/s/ Brett R. Budzinski, Attorney-in-Fact for Takeda Pharmaceuticals U.S.A., Inc. | 09/08/2017 | |
/s/ Brett R. Budzinski, Attorney-in-Fact for Takeda Pharmaceutical International AG | 09/08/2017 | |
/s/ Brett R. Budzinski, Attorney-in-Fact for Takeda Pharma A/S | 09/08/2017 | |
/s/ Brett R. Budzinski, Attorney-in-Fact for Takeda A/S | 09/08/2017 | |
/s/ Brett R. Budzinski, Attorney-in-Fact for Takeda Europe Holdings B.V. | 09/08/2017 | |
** 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. |