| 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) 12/30/2016 | 3. Issuer Name and Ticker or Trading Symbol Nabriva Therapeutics AG [ NBRV ] | |||||||||||||
| 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 | |||
|---|---|---|---|
| 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 Shares(1) | 159 | D | |
| Common Shares(2) | 15,582 | I | By grantor retained annuity trust |
| 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 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 | (3) | 07/05/2025 | Common Shares | 15,827 | (4) | D | |
| Stock Option | (5) | 07/05/2025 | Common Shares | 19,690 | (6) | D | |
| Stock Option | (7) | 02/04/2026 | Common Shares | 15,100 | (8) | D | |
| Explanation of Responses: |
| 1. Represented by 1,595 American Depositary Shares. |
| 2. Represented by 155,817 American Depositary Shares held by the Colin Broom Grantor Trusts I, II and III. |
| 3. This option was granted on July 6, 2015. Vesting began on August 31, 2014 and ends on August 31, 2018. Twenty-five percent (25%) of the option vested on August 31, 2015, and the remaining seventy-five percent (75%) vests on a monthly pro-rata basis over the remaining vesting period. |
| 4. The exercise price is 66.18 Euro. |
| 5. This option was granted on July 6, 2015. Vesting began on July 31, 2015 and ends on July 31, 2019. Twenty-five percent (25%) of the option vested on July 31, 2016, and the remaining seventy-five percent (75%) vests on a monthly pro-rata basis over the remaining vesting period. |
| 6. The exercise price is 66.18 Euro. |
| 7. This option was granted on February 5, 2016. Vesting began on February 29, 2016 and ends on February 29, 2020. Twenty-five percent (25%) of the option will vest on February 28, 2017, and the remaining seventy-five percent (75%) vests on a monthly pro-rata basis over the remaining vesting period. |
| 8. The exercise price is 74.45 Euro. |
| Remarks: |
| Exhibit Index: 24.1 - Power of Attorney |
| /s/ Gary L. Sender, by power of attorney | 12/30/2016 | |
| ** 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. | ||
