Statement of Changes in Beneficial Ownership (4)
20 Maio 2022 - 08:30PM
Edgar (US Regulatory)
FORM 4
[ ] Check this box if no longer subject to Section
16. Form 4 or Form 5 obligations may continue. See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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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 * AFEYAN NOUBAR |
2. Issuer Name and Ticker or Trading
Symbol Moderna, Inc. [ MRNA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
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(Last)
(First)
(Middle)
C/O FLAGSHIP PIONEERING, INC., 55 CAMBRIDGE PARKWAY, SUITE
800E |
3. Date of Earliest Transaction (MM/DD/YYYY)
5/18/2022
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(Street)
CAMBRIDGE, MA 02142
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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 Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
5/18/2022 |
|
S(1) |
|
10000 |
D |
$138.38 |
2567209 (2) |
D |
|
Common Stock |
|
|
|
|
|
|
|
12882819 (3) |
I |
By Flagship Ventures Fund IV, L.P. and Flagship
Ventures Fund IV-Rx, L.P. (3) |
Common Stock |
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|
|
|
|
|
|
3924 (4) |
I |
By Flagship Pioneering, Inc. (4) |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially
Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of
Responses: |
(1) |
These sales were effected by
the reporting person pursuant to a Rule 10b5-1 trading plan adopted
on September 15, 2021, as amended on March 11, 2022. |
(2) |
Includes shares received in
prior distributions-in-kind from Flagship VentureLabs IV LLC
("VentureLabs IV"), Flagship Ventures Fund IV, L.P. ("Flagship Fund
IV"), Flagship Fund Ventures Fund IV-Rx, L.P. ("Flagship Fund
IV-Rx") and Flagship Fund IV General Partner LLC ("Flagship Fund IV
GP") made in accordance with the exemptions afforded by Rule 16a-13
and Rule 16a-9 of the Securities Exchange Act of 1934, as
amended. |
(3) |
10,801,059 shares are held
directly by Flagship Fund IV (which reflects prior
distributions-in-kind from VentureLabs IV) and 2,081,760 shares are
held directly by Flagship Fund IV-Rx. Flagship Fund IV GP is the
general partner of each of Flagship Fund IV and Flagship Fund
IV-Rx. The reporting person is the sole manager of Flagship Fund IV
GP and disclaims beneficial ownership of such shares except to the
extent of his pecuniary interest therein. |
(4) |
3,924 shares are held
directly by Flagship Pioneering, Inc. ("Flagship Pioneering"). The
reporting person is the CEO and sole stockholder of Flagship
Pioneering and disclaims beneficial ownership of such shares except
to the extent of his pecuniary interest therein. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
AFEYAN NOUBAR
C/O FLAGSHIP PIONEERING, INC.
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE, MA 02142 |
X |
|
|
|
Signatures
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Noubar B. Afeyan, Ph.D. By: /s/ Noubar B. Afeyan,
Ph.D. |
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5/20/2022 |
**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 4(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 control number. |
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