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) 08/05/2021 | 3. Issuer Name and Ticker or Trading Symbol Adagio Therapeutics, Inc. [ ADGI ] | |||||||||||||
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 | 127,060(1) | 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) | 09/27/2030 | Common Stock | 254,115 | 0.78 | D | |
Stock Option (Right to Buy) | (3) | 01/12/2031 | Common Stock | 254,115 | 4.61 | D | |
Stock Option (Right to Buy) | (4) | 05/06/2031 | Common Stock | 284,945 | 10.14 | D | |
Stock Option (Right to Buy) | (5) | 07/03/2021 | Common Stock | 192,565 | 12.8 | D |
Explanation of Responses: |
1. One quarter (1/4) of the shares vested on June 15, 2021, and thereafter, the remainder of the shares vest in 36 equal monthly installments on the 15th day of each month, subject to the Reporting Person's continuous service. |
2. One quarter (1/4) of the options vested on July 21, 2021, and thereafter, the remainder of the options vest in 36 equal monthly installments on the 21st day of each month, subject to the Reporting Person's continuous service on each vesting date. |
3. One quarter (1/4) of the options shall vest on September 29, 2021, and thereafter, the remainder of the options shall vest in 36 equal monthly installments on the 29th day of each month, subject to the Reporting Person's continuous service on each vesting date. |
4. One quarter (1/4) of the options shall vest on May 6, 2022, and thereafter, the remainder of the options shall vest in 36 equal monthly installments on the 6th day of each month, subject to the Reporting Person's continuous service on each vesting date. |
5. One quarter (1/4) of the options shall vest on July 4, 2022, and thereafter, the remainder of the options shall vest in 36 equal monthly installments on the 4th day of each month, subject to the Reporting Person's continuous service on each vesting date. |
Remarks: |
Exhibit List -- Exhibit 24 -- Power of Attorney |
/s/ Dorothy Vinsky, Attorney-in-Fact | 08/05/2021 | |
** 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. |