Michelle Siegert Form 3 Pulmatrix / Michelle Siegert ownership change

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^*

Siegert Michelle

(Last) (First) (Middle)

C/O PULMATRIX, INC.

99 HAYDEN AVE, SUITE 390

(Street)

LEXINGTON MA 02421

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
11/13/2019

3. Issuer Name and Ticker or Trading Symbol
Pulmatrix, Inc. [ PULM ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Vice President, Finance

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

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	1,186	D

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
Employee Stock Option (Right to Buy)	08/23/2014	09/20/2021	Common Stock	119	22.1	D
Employee Stock Option (Right to Buy)	11/01/2015	06/08/2022	Common Stock	445	20.3	D
Employee Stock Option (Right to Buy)	10/01/2015	10/11/2023	Common Stock	315	18.8	D
Employee Stock Option (Right to Buy)	06/16/2019	06/16/2025	Common Stock	1,087	118	D
Employee Stock Option (Right to Buy)	06/16/2019	06/24/2025	Common Stock	160	110	D
Employee Stock Option (Right to Buy)	08/13/2019	08/13/2025	Common Stock	1,500	59.1	D
Employee Stock Option (Right to Buy)	(1)	02/03/2026	Common Stock	1,320(1)	28	D
Employee Stock Option (Right to Buy)	(2)	03/20/2027	Common Stock	660(2)	27.8	D
Employee Stock Option (Right to Buy)(3)	(3)	06/05/2028	Common Stock	18,100(3)	4.68	D
Employee Stock Option (Right to Buy)	(4)	05/16/2029	Common Stock	25,000(4)	1.06	D

Explanation of Responses:

1. Twenty five percent (25%) of the shares subject to the option vested on February 3, 2017, and the remaining Seventy Five Percent (75%) of the shares shall vest in equal monthly installments for thirty six (36) successive months after February 3, 2017. 1,239 shares subject to this option are vested and currently exercisable.

2. Twenty five percent (25%) of the shares subject to the option vested on March 20, 2018, and the remaining Seventy Five Percent (75%) of the shares shall vest in equal installments for thirty six (36) successive months after March 20, 2018. 431 shares subject to this option are vested and currently exercisable.

3. This grant is a combination of an employee stock option (right to buy) and a non-qualified stock option (right to buy) (the "Combined Option"). Twenty five percent (25%) of the shares subject to the Combined Option vested on June 5, 2018, and the remaining Seventy Five Percent (75%) of the shares shall vest in equal monthly installments for thirty six (36) successive months after June 5, 2018. 10,938 shares subject to this Combined Option are vested and currently exercisable.

4. This grant shall vest in equal monthly installments for forty eight (48) successive months after May 16, 2019. 3,125 shares subject to this option are vested and currently exercisable

Remarks:

Exhibit 24.1 Power of Attorney (furnished herewith)

	/s/ Teofilo Raad, attorney-in-fact	11/20/2019
	** 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.
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