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)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/02/2023 |
3. Issuer Name and Ticker or Trading Symbol
Immunome Inc. [ IMNM ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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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 | 150,432(1) | D |
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) | 09/26/2032 | Common Stock | 198,565(1) | 1.35 | D | |
Stock Option (Right to Buy) | (2) | 01/18/2033 | Common Stock | 1,191,399(1) | 1.35 | D | |
Stock Option (Right to Buy) | (3) | 06/28/2033 | Common Stock | 2,137,080 | 5.91 | D |
Explanation of Responses: |
1. Dr. Siegall was elected as a member of the board of directors and appointed as President and Chief Executive Officer of the Issuer effective immediately after the Effective Time (as defined in the Agreement and Plan of Merger and Reorganization, dated June 29, 2023 (the "Merger Agreement"), by and among the Issuer, Ibiza Merger Sub, Inc., and Morphimmune Inc.). In connection with the Closing (as defined in the Merger Agreement) and prior to Dr. Siegall joining the board of directors and being appointed an executive officer of the Issuer, Dr. Siegall exchanged his (i) options to acquire shares of common stock of Morphimmune Inc. for options to acquire shares of the Issuer and (ii) his shares of capital stock of Morphimmune for shares of common stock of the Issuer. |
2. In connection with the Closing (as defined in the Merger Agreement), all the shares underlying the option became fully vested and exercisable. |
3. 25% of the shares vest and become exercisable at the one-year anniversary of the consummation of the merger contemplated by the Merger Agreement; and 75% of the shares vest and become exercisable in thirty-six (36) successive equal monthly installments thereafter. |
Remarks: |
See Attached Exhibit 24 |
/s/ Sandra Stoneman, Attorney-in-Fact | 10/02/2023 | |
** 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. |