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) 06/18/2020 |
3. Issuer Name and Ticker or Trading Symbol
Repare Therapeutics Inc. [ RPTX ] |
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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 Shares | 651,462 | I | See Footnote(1) |
Common Shares | 49,580 | I | See Footnote(2) |
Common Shares | 21,692 | I | See Footnote(3) |
Common Shares | 19,596 | I | See Footnote(4) |
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 | ||||
Class A Preferred Shares | (5) | (5) | Common Shares | 2,054,198 | (5) | I | See Footnote(1) |
Class A Preferred Shares | (5) | (5) | Common Shares | 156,335 | (5) | I | See Footnote(2) |
Class A Preferred Shares | (5) | (5) | Common Shares | 68,398 | (5) | I | See Footnote(3) |
Class A Preferred Shares | (5) | (5) | Common Shares | 61,791 | (5) | I | See Footnote(4) |
Class A Preferred Shares | (5) | (5) | Common Shares | 2,443,883 | (5) | I | See Footnote(6) |
Class B Preferred Shares | (5) | (5) | Common Shares | 111,361 | (5) | I | See Footnote(1) |
Class B Preferred Shares | (5) | (5) | Common Shares | 8,475 | (5) | I | See Footnote(2) |
Class B Preferred Shares | (5) | (5) | Common Shares | 3,708 | (5) | I | See Footnote(3) |
Class B Preferred Shares | (5) | (5) | Common Shares | 3,350 | (5) | I | See Footnote(4) |
Class B Preferred Shares | (5) | (5) | Common Shares | 875,568 | (5) | I | See Footnote(6) |
Class B Preferred Shares | (5) | (5) | Common Shares | 458,282 | (5) | I | See Footnote(7) |
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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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. The securities are held by Versant Venture Capital V, L.P. ("VVC V"). Versant Ventures V, LLC ("VV V") is the sole general partner of VVC V and may be deemed to have voting and investment power over the securities held by VVC V and as a result may be deemed to have beneficial ownership over such securities. VV V disclaims beneficial ownership of the shares held by VVC V, except to the extent of its pecuniary interest therein. |
2. The securities are held by Versant Venture Capital V (Canada) LP ("VVC V (Canada)"). Versant Ventures V (Canada) GP-GP, Inc. ("VV V (Canada) GP") is the sole general partner of Versant Ventures V (Canada), L.P. ("VV V (Canada)") and VV V (Canada) is the sole general partner of VVC V (Canada). By virtue of such relationships, VV V (Canada) GP and VV V (Canada) may be deemed to have voting and investment power over the securities held by VVC V (Canada) and as a result may be deemed to have beneficial ownership over such securities. Each of VV V (Canada) and VV V (Canada) GP disclaims beneficial ownership of the shares held by VVC V (Canada), except to the extent of its pecuniary interest therein. |
3. The securities are held by Versant Ophthalmic Affiliates Fund I, L.P. ("VOAF I"). VV V is the sole general partner of VOAF I and may be deemed to have voting and investment power over the securities held by VOAF I and as a result may be deemed to have beneficial ownership over such securities. VV V disclaims beneficial ownership of the shares held by VOAF I, except to the extent of its pecuniary interest therein. |
4. The securities are held by Versant Affiliates Fund V, L.P. ("VAF V"). VV V is the sole general partner of VAF V and may be deemed to have voting and investment power over the securities held by VAF V and as a result may be deemed to have beneficial ownership over such securities. VV V disclaims beneficial ownership of the shares held by VAF V, except to the extent of its pecuniary interest therein. |
5. Each Class A Preferred Share and Class B Preferred Share is convertible at any time, at the holder's election, into Common Shares, on a one-for-one basis, has no expiration date and will convert into Common Shares upon the closing of the Issuer's initial public offering. |
6. The securities are held by Versant Venture Capital VI, L.P. ("VVC VI"). Versant Ventures VI GP-GP, LLC ("VV VI GP") is the sole general partner of Versant Ventures VI GP, L.P. ("VV VI") and VV VI is the sole general partner of VVC VI. By virtue of such relationships, VV VI GP and VV VI may be deemed to have voting and investment power over the securities held by VVC VI and as a result may be deemed to have beneficial ownership over such securities. Each of VV VI GP and VV VI disclaims beneficial ownership of the shares held by VVC VI, except to the extent of its pecuniary interest therein. |
7. The securities are held by Versant Vantage I, L.P. ("VV I"). Versant Vantage I GP-GP, LLC ("VV I GP-GP") is the sole general partner of Versant Vantage I GP, L.P. ("VV I GP") and VV I GP is the sole general partner of VV I. By virtue of such relationships, VV I GP and VV I GP-GP may be deemed to have voting and investment power over the securities held by VV I and as a result may be deemed to have beneficial ownership over such securities. Each of VV I GP-GP and VV I GP disclaims beneficial ownership of the shares held by VV I, except to the extent of its pecuniary interest therein. |
Remarks: |
1 of 2: Since there are 13 joint filers with this transaction and EDGAR will not allow for entry of more than 10 joint filers, this Form 3 is being filed in conjunction with a Form 3 for Versant Vantage I, LP, Versant Vantage I GP, L.P. and Versant Vantage I GP-GP, LLC. |
/s/ Robin L. Praeger, Managing Director of Versant Ventures V, LLC | 06/18/2020 | |
/s/ Robin L. Praeger, Managing Director of Versant Ventures V, LLC, general partner of Versant Ophthalmic Affiliates Fund I, L.P. | 06/18/2020 | |
/s/ Robin L. Praeger, Managing Director of Versant Ventures V, LLC, general partner of Versant Affiliates Fund V, L.P. | 06/18/2020 | |
/s/ Robin L. Praeger, Director of Versant Ventures V GP-GP (Canada), Inc., general partner of Versant Ventures V (Canada) L.P., the general partner of Versant Venture Capital V (Canada) LP | 06/18/2020 | |
/s/ Robin L. Praeger, Director of Versant Ventures V GP-GP (Canada), Inc., general partner of Versant Ventures V (Canada) L.P. | 06/18/2020 | |
s/ Robin L. Praeger, Director of Versant Ventures V GP-GP (Canada), Inc., general partner of Versant Ventures V (Canada) L.P. | 06/18/2020 | |
s/ Robin L. Praeger, Director of Versant Ventures V GP-GP (Canada), Inc. | 06/18/2020 | |
/s/ Robin L. Praeger, Managing Director of Versant Ventures VI GP-GP LLC, general partner of Versant Ventures VI GP, L.P., the general partner of Versant Venture Capital VI, L.P. | 06/18/2020 | |
/s/ Robin L. Praeger, Managing Director of Versant Ventures VI GP-GP LLC, general partner of Versant Ventures VI GP, L.P. | 06/18/2020 | |
/s/ Robin L. Praeger, Managing Director of Versant Ventures VI GP-GP LLC | 06/18/2020 | |
** 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. |