1. Name and Address of Reporting Person*Medicxi Ventures Management (Jersey) Ltd | C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) | 2. Date of Event Requiring Statement (Month/Day/Year) 05/27/2021 | 3. Issuer Name and Ticker or Trading Symbol Centessa Pharmaceuticals plc [ CNTA ] |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable) | Director | X | 10% Owner | | Officer (give title below) | | Other (specify below) | | | 5. If Amendment, Date of Original Filed (Month/Day/Year) 05/27/2021 |
6. Individual or Joint/Group Filing (Check Applicable Line) | Form filed by One Reporting Person | X | Form filed by More than One Reporting Person | |
1. Name and Address of Reporting Person*Medicxi Ventures Management (Jersey) Ltd | C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person* C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person* C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person*Medicxi Ventures I GP Ltd | C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person* C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person*Medicxi Growth Co-Invest I LP | C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person* C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person* C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person*Medicxi Secondary Co-Invest I LP | C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
1. Name and Address of Reporting Person*Medicxi Secondary I GP Ltd. | C/O INTERTRUST FUND SERVICES (JERSEY) | LIMITED 44 ESPLANADE | (Street) |
| Medicxi Ventures Management (Jersey) Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Ventures I LP, By: Medicxi Ventures Management (Jersey) Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Co-Invest I LP, By: Medicxi Ventures Management (Jersey) Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Ventures I GP Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Growth I LP, By: Medicxi Ventures Management (Jersey) Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Growth Co-Invest I LP, By: Medicxi Ventures Management (Jersey) Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Growth I GP Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Secondary I LP, By: Medicxi Ventures Management (Jersey) Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Secondary Co-Invest I LP, By: Medicxi Ventures Management (Jersey) Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| Medicxi Secondary I GP Limited, By: /s/ Andrew Jeanne, Its: Director | 06/03/2021 |
| ** 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. |