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) 08/18/2020 | 3. Issuer Name and Ticker or Trading Symbol Inhibrx, Inc. [ INBX ] | |||||||||||||
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 | 515,835 | I | By the Forsyth Family Trust Dated July 20, 2001(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 | ||||
Stock Option (right to buy) | (2) | 11/26/2028 | Common Stock | 17,259 | 10.52 | D | |
Series Mezzanine 2 Preferred Stock | (3) | (3) | Common Stock | 82,422 | (3) | I | By the Forsyth Family Trust Dated July 20, 2001(1) |
Explanation of Responses: |
1. The reporting person is a trustee of the Forsyth Family Trust Dated July 20, 2001 and, in such capacity, may each be deemed to indirectly beneficially own the securities owned by the Forsyth Family Trust Dated July 20, 2001. |
2. Twenty-five percent (25%) of the total shares subject to the stock option became exercisable on November 26, 2019, with the balance to vest and become exercisable in equal successive monthly installments for thirty-six (36) months thereafter. |
3. These securities are convertible into the number of shares of common stock shown in column 3, calculated using the conversion ratio set forth in the issuer's certificate of incorporation, as amended, at any time at the option of the holder and automatically upon the closing of the issuer's initial public offering. These securities have no expiration date. |
Remarks: |
Exhibit List Exhibit 24 - Power of Attorney |
/s/ Kelly D. Deck, attorney-in-fact | 08/18/2020 | |
** 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 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. |