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)
| 2. Date of Event Requiring Statement (Month/Day/Year) 07/16/2020 | 3. Issuer Name and Ticker or Trading Symbol Pandion Therapeutics, Inc. [ PAND ] | |||||||||||||
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) |
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 | ||||
Series A Preferred Stock | (1) | (1) | Common Stock | 2,576,564(1)(2) | (1) | I | See Footnote(3) |
Series B Preferred Stock | (4) | (4) | Common Stock | 473,409(4)(5) | (4) | I | See Footnote(3) |
Explanation of Responses: |
1. The Series A Preferred Stock is convertible into Common Stock on a 5.0994-for-one basis into the number of shares of Common Stock shown in Column 3 at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering. The shares have no expiration date. |
2. Consists of 2,576,564 shares of Common Stock issuable upon conversion of Series A Preferred Stock held by Roche Finance Ltd ("Roche Finance"). |
3. Roche Finance is the direct beneficial owner of these securities of the Issuer. Roche Finance is a wholly owned subsidiary of Roche Holding Ltd. Roche Holding Ltd is the indirect beneficial owner of these securities of the Issuer. Mr. Mutz disclaims beneficial ownership of the securities except to the extent of his pecuniary interest therein, if any. Mr. Mutz also disclaims beneficial ownership of any securities of the Issuer that may be or are beneficially owned by any other person or persons other than Mr. Mutz. This Form 3 shall not be deemed an admission that Mr. Mutz or any other person is a beneficial owner of any securities of the Issuer for any purpose, other than the securities reported in this Form 3. |
4. The Series B Preferred Stock is convertible into Common Stock on a 5.0994-for-one basis into the number of shares of Common Stock shown in Column 3 at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering. The shares have no expiration date. |
5. Consists of 473,409 shares of Common Stock issuable upon conversion of Series B Preferred Stock held by Roche Finance. |
Remarks: |
Exhibit Index: 24.1 Power of Attorney |
/s/ Edward Freedman, as attorney-in-fact for Mitchell W. Mutz | 07/16/2020 | |
** 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. |