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) 12/17/2021 | 3. Issuer Name and Ticker or Trading Symbol Relay Therapeutics, Inc. [ RLAY ] | |||||||||||||
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(1) | 23,407 | 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) | (2) | 10/09/2029 | Common Stock | 143,926 | 5.042 | D | |
Stock Option (Right to Buy) | (3) | 03/01/2030 | Common Stock | 13,861 | 5.22 | D | |
Stock Option (Right to Buy) | (4) | 03/01/2030 | Common Stock | 47,522 | 5.22 | D | |
Stock Option (Right to Buy) | (5) | 03/25/2031 | Common Stock | 28,000 | 34.25 | D |
Explanation of Responses: |
1. Includes 12,250 restricted stock units ("RSUs") granted to the reporting person pursuant to the Issuer's 2020 Stock Option and Incentive Plan. Each RSU represents a contingent right to receive one share of the Issuer's common stock upon vesting. The RSUs commenced vesting in 16 equal quarterly installments following the grant date of March 26, 2021, subject to the reporting person's continued service with the Issuer through each vesting date. |
2. 24,239 shares underlying this option have vested and the remainder shall vest in equal quarterly installments from January 21, 2022 to October 21, 2023, subject to the reporting person's continued service with the Issuer through each vesting date. |
3. 2,970 shares underlying this option have vested and the remainder shall vest in equal quarterly installments from December 23, 2021 to June 23, 2024, subject to the reporting person's continued service with the Issuer through each vesting date. |
4. 11,880 shares underlying this option have vested and the remainder shall vest in equal quarterly installments from March 11, 2022 to December 11, 2024, subject to the reporting person's continued service with the Issuer through each vesting date. |
5. 3,500 shares underlying this option have vested and the remainder shall vest in equal quarterly installments from December 26, 2021 to March 26, 2025, subject to the reporting person's continued service with the Issuer through each vesting date. |
Remarks: |
Title: Executive Vice President, Chief People Experience Officer Exhibit 24 - Power of Attorney |
/s/ Brian Adams, as Attorney-in-Fact | 12/27/2021 | |
** 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. |