SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Chardonnet Laurent

(Last) (First) (Middle)
C/O AXCELLA HEALTH INC.
840 MEMORIAL DRIVE

(Street)
CAMBRIDGE MA 02139

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Axcella Health Inc. [ AXLA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
3. Date of Earliest Transaction (Month/Day/Year)
02/09/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
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. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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 10/30/2020 A(1) V 2,601 A $3.6(2) 6,266 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: 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
Restricted Stock Units (3) 02/09/2021 A 60,000 (4) (4) Common Stock 60,000 $0 60,000 D
Stock Option (Right to Buy) $6.59 02/09/2021 A 120,000 (5) 02/08/2031 Common Stock 120,000 $0 120,000 D
Stock Option (Right to Buy) $3.4 02/09/2021 A(6) 25,000 (7) 12/17/2029 Common Stock 25,000 $0 25,000 D
Explanation of Responses:
1. The reporting person is voluntarily reporting the acquisition of shares of the Issuer's common stock pursuant to the Axcella Health Inc. Employee Stock Purchase Plan ("ESPP") for the ESPP purchase period of May 1, 2020 to October 30, 2020.
2. In accordance with the ESPP, these shares were purchased based on 85% of the closing price of the Issuer's common stock on October 30, 2020.
3. Each restricted stock unit ("RSU") represents a contingent right to receive one share of AXLA common stock.
4. The restricted stock units vest as follows: 1/3 of the grant shall vest on February 9, 2023 and the remaining 2/3 of the grant shall vest on February 9, 2024.
5. 25% of this option shall vest and become exercisable on February 9, 2022, with the remainder vesting in 12 equal quarterly installments thereafter.
6. On December 18, 2019, the reporting person was granted an option to purchase 25,000 shares of AXLA common stock, subject to the satisfaction of certain performance criteria. On February 9, 2021, the Issuer's Board of Directors confirmed that the performance criteria had been met.
7. This option shall vest and become exercisable in eight equal quarterly installments, with the first installment having vested on August 31, 2020.
Remarks:
Exhibit 24 - Power of Attorney
By: /s/ Laurent Chardonnet 02/11/2021
** 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 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).
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