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 |
|
1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 06/11/2020 | 3. Issuer Name and Ticker or Trading Symbol Avidity Biosciences, Inc. [ RNA ] | |||||||||||||
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)
|
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 Stock | 189,618(1) | D | |
Common Stock | 616,259 | I | By family trust |
Common Stock | 35,553 | I | By trust FBO Child 1 |
Common Stock | 35,553 | I | By trust FBO Child 2 |
Common Stock | 11,851 | I | By trust FBO Child 3 |
Common Stock | 11,851 | I | By trust FBO Child 4 |
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 | ||||
Series A Preferred Stock | (2) | (2) | Common Stock | 120,837 | 0.00 | I | By family trust |
Series B Preferred Stock | (2) | (2) | Common Stock | 16,769 | 0.00 | I | By family trust |
Series C Preferred Stock | (2) | (2) | Common Stock | 51,436 | 0.00 | I | By family trust |
Explanation of Responses: |
1. Includes 59,256 shares subject to repurchase by the Issuer, which shares will vest in 15 equal monthly installments beginning on June 29, 2020. |
2. The 254,907 shares of Series A Preferred Stock, 35,374 shares of Series B Preferred Stock and 108,504 shares of Series C Preferred Stock are convertible at any time, at the holder's election, at a ratio of one-for-2.1095 shares of the Issuer's common stock, and have no expiration date. In addition, effective immediately prior to the closing of the Issuer's initial public offering of its common stock, each share of preferred stock will automatically convert at a ratio of one-for-2.1095 shares of the Issuer's common stock. |
Remarks: |
/s/ John W. Wallen III, Ph.D., J.D., Attorney-in-Fact | 06/11/2020 | |
** 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. |