| 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) 05/02/2018 | 3. Issuer Name and Ticker or Trading Symbol Unity Biotechnology, Inc. [ UBX ] | |||||||||||||
| 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) |
| Common Stock | 94,718 | 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) | (1) | 09/26/2027 | Common Stock | 125,620 | 3.43 | D | |
| Stock Option (Right to Buy) | (2)(3) | 09/26/2027 | Common Stock | 86,440 | 3.43 | D | |
| Series C Preferred Stock | (4) | (5) | Common Stock | 1,630 | (4) | D | |
| Explanation of Responses: |
| 1. 25% of the shares subject to the option vests on September 5, 2018, and the remaining shares subject to the option vest in 36 successive, equal monthly installments on each monthly anniversary thereafter, subject to the reporting person's continued employment or service relationship with the Issuer on each such vesting date. |
| 2. 1/3 of the shares underlying the option will be scheduled to vest upon i) the closing of a financing where the Issuer sells shares of its equity securities to institutional investors at a price per share of at least $36.88, ii) a change in control with aggregate proceeds payable to holders of the Issuer's common stock at a price per share of at least $36.88, or iii) the Issuer attains an average trading price after IPO of at least $36.88 as measured by a trailing 30 day volume-weighted average price (VWAP) (continued) |
| 3. 2/3 of the shares underlying the option will vest upon i) the closing of a financing where the Company sells shares of its equity securities to institutional investors with a pre-money valuation of at least $2.5B, ii) a change in control with aggregate proceeds payable to holders of the Company's common stock at a valuation of the Company of at least $2.5B, or iii) the Company attains a market capitalization after IPO of at least $2.5B as measured by a trailing 30 day VWAP, in each case subject to the reporting person's continuing services to the Issuer through each applicable vesting date. |
| 4. The shares of the Issuer's Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1 basis immediately prior to the consummation of the Issuer's initial public offering. |
| 5. The expiration date is not relevant to the conversion of these securities. |
| /s/ Tamara L. Tompkins, Attorney-in-Fact for Robert C. Goeltz II | 05/02/2018 | |
| ** 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. | ||
