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) 04/07/2020 | 3. Issuer Name and Ticker or Trading Symbol Keros Therapeutics, Inc. [ KROS ] | |||||||||||||
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) |
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 | ||||
Series A Preferred Stock | (1) | (1) | Common Stock | 1,382,295 | (1) | D(2) | |
Series B-1 Preferred Stock | (1) | (1) | Common Stock | 343,270 | (1) | D(2) | |
Series C Preferred Stock | (1) | (1) | Common Stock | 167,537 | (1) | D(2) |
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. Each share of Series A Preferred Stock, Series B-1 Preferred Stock and Series C Preferred Stock is convertible at any time, at the holder's election, into Common Stock, on a one-for-one basis, has no expiration date and will convert into shares of Common Stock upon the closing of the Issuer's initial public offering. |
2. The securities are held by Arkin Bio Ventures Limited Partnership ("Arkin Bio"). Arkin Bio Venture Partners Ltd. is the general partner of Arkin Bio. Moshe Arkin is the sole shareholder and chairman of the board of Arkin Bio Venture Partners Ltd. |
Remarks: |
Exhibit List: Exhibit 24.1 - Power of Attorney by Arkin Bio Ventures Limited Partnership Exhibit 24.2 - Power of Attorney by Arkin Bio Venture Partners Ltd. Exhibit 24.3 - Power of Attorney by Moshe Arkin |
Arkin Bio Ventures Limited Partnership, By: Its General Partner, Arkin Bio Venture Partners Ltd., By: Moshe Arkin, Director, By: /s/ Yair Ben Yosef, attorney-in-fact | 04/07/2020 | |
Arkin Bio Venture Partners Ltd., By: Moshe Arkin, Director, By: /s/ Yair Ben Yosef, attorney-in-fact | 04/07/2020 | |
Moshe Arkin, By: /s/ Yair Ben Yosef, attorney-in-fact | 04/07/2020 | |
** 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. |