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 |
|
1. Name and Address of Reporting Person*
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 04/30/2020 |
3. Issuer Name and Ticker or Trading Symbol
Lyra Therapeutics, Inc. [ LYRA ] |
|||||||||||||
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)
|
Table I - Non-Derivative Securities Beneficially Owned | |||
---|---|---|---|
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) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
---|---|---|---|---|---|---|---|
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 | ||||
Series A-1/A Convertible Preferred Stock | (1) | (1) | Common Stock | 33,572 | (1) | I | See footnote(2) |
Series A-1/A Convertible Preferred Stock | (1) | (1) | Common Stock | 16,455 | (1) | I | See footnote(3) |
Series A-1/A Convertible Preferred Stock | (1) | (1) | Common Stock | 50,027 | (1) | I | See footnote(4) |
Series A-1/B Convertible Preferred Stock | (1) | (1) | Common Stock | 32,066 | (1) | I | See footnote(2) |
Series A-1/B Convertible Preferred Stock | (1) | (1) | Common Stock | 15,717 | (1) | I | See footnote(3) |
Series A-1/B Convertible Preferred Stock | (1) | (1) | Common Stock | 47,783 | (1) | I | See footnote(4) |
Series A-1/C Convertible Preferred Stock | (1) | (1) | Common Stock | 88,500 | (1) | I | See footnote(2) |
Series A-1/C Convertible Preferred Stock | (1) | (1) | Common Stock | 43,377 | (1) | I | See footnote(3) |
Series A-1/C Convertible Preferred Stock | (1) | (1) | Common Stock | 56,519 | (1) | I | See footnote(4) |
Series A-2 Convertible Preferred Stock | (1) | (1) | Common Stock | 94,849 | (1) | I | See footnote(2) |
Series A-2 Convertible Preferred Stock | (1) | (1) | Common Stock | 46,489 | (1) | I | See footnote(3) |
Series A-2 Convertible Preferred Stock | (1) | (1) | Common Stock | 60,573 | (1) | I | See footnote(4) |
Series A-3 Convertible Preferred Stock | (1) | (1) | Common Stock | 133,039 | (1) | I | See footnote(2) |
Series A-3 Convertible Preferred Stock | (1) | (1) | Common Stock | 65,208 | (1) | I | See footnote(3) |
Series A-3 Convertible Preferred Stock | (1) | (1) | Common Stock | 84,963 | (1) | I | See footnote(4) |
Series A-4 Convertible Preferred Stock | (1) | (1) | Common Stock | 108,614 | (1) | I | See footnote(2) |
Series A-4 Convertible Preferred Stock | (1) | (1) | Common Stock | 53,236 | (1) | I | See footnote(3) |
Series A-4 Convertible Preferred Stock | (1) | (1) | Common Stock | 69,364 | (1) | I | See footnote(4) |
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 90,613 | (1) | I | See footnote(2) |
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 44,413 | (1) | I | See footnote(3) |
Series B Convertible Preferred Stock | (1) | (1) | Common Stock | 57,868 | (1) | I | See footnote(4) |
Series C Convertible Preferred Stock | (1) | (1) | Common Stock | 70,200 | (1) | I | See footnote(2) |
Series C Convertible Preferred Stock | (1) | (1) | Common Stock | 34,408 | (1) | I | See footnote(3) |
Series C Convertible Preferred Stock | (1) | (1) | Common Stock | 44,832 | (1) | I | See footnote(4) |
Common Warrants | 01/17/2020 | 01/10/2030 | Common Stock | 21,060 | $8.63 | I | See footnote(2) |
Common Warrants | 01/17/2020 | 01/10/2030 | Common Stock | 10,322 | $8.63 | I | See footnote(3) |
Common Warrants | 01/17/2020 | 01/10/2030 | Common Stock | 13,449 | $8.63 | I | See footnote(4) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
| ||||||||||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
|
Explanation of Responses: |
1. The preferred stock is convertible at any time, at the holder's election and has no expiration date. Each share of preferred stock shall be automatically converted into 0.0289998 shares of common stock upon the closing of the Issuer's initial public offering. |
2. The reportable securities are owned directly by North Bridge Venture Partners V-A, L.P. ("NBVP V-A"). North Bridge Venture Management V, L.P. ("NBVM V") is the sole general partner of NBVP V-A and North Bridge Venture Management GP, LLC ("NBVM GP") is the sole general partner of NBVM V. Each of Edward T. Anderson ("Anderson"), a member of the Issuer's board of directors, and Richard A. D'Amore ("D'Amore") are the managing members of NBVM GP and may be deemed to have shared voting and dispositive power over the shares held by NBVP V-A. Each of NBVM V, NBVM GP, Anderson and D'Amore disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any one of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their respective pecuniary interests therein. |
3. The reportable securities are owned directly by North Bridge Venture Partners V-B, L.P. ("NBVP V-B"). NBVM V is the sole general partner of NBVP V-B and NBVM GP is the sole general partner of NBVM V. Each of Anderson, a member of the Issuer's board of directors, and D'Amore are the managing members of NBVM GP and may be deemed to have shared voting and dispositive power over the shares held by NBVP V-B. Each of NBVM V, NBVM GP, Anderson and D'Amore disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any one of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their respective pecuniary interests therein. |
4. The reportable securities are owned directly by North Bridge Venture Partners VI, L.P. ("NBVP VI"). North Bridge Venture Management VI, L.P. ("NBVM VI") is the sole general partner of NBVP VI and NBVM GP is the sole general partner of NBVM VI. Each of Anderson, a member of the Issuer's board of directors, and D'Amore are the managing members of NBVM GP and may be deemed to have shared voting and dispositive power over the shares held by NBVP VI. Each of NBVM VI, NBVM GP, Anderson and D'Amore disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any one of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their respective pecuniary interests therein. |
Remarks: |
North Bridge Venture Partners V-A, L.P., /s/ Edward T. Anderson, Manager of NBVM GP, general partner of North Bridge Venture Management V, L.P., general partner of North Bridge Venture Partners V-A, L.P. | 04/30/2020 | |
North Bridge Venture Partners V-B, L.P., /s/ Edward T. Anderson, Manager of NBVM GP, general partner of North Bridge Venture Management V, L.P., general partner of North Bridge Venture Partners V-B, L.P. | 04/30/2020 | |
North Bridge Venture Partners VI, L.P., /s/ Edward T. Anderson, Manager of NBVM GP, general partner of North Bridge Venture Management VI, L.P., general partner of North Bridge Venture Partners VI, L.P. | 04/30/2020 | |
North Bridge Venture Management V, L.P., /s/ Edward T. Anderson, Manager of NBVM GP, general partner of North Bridge Venture Management V, L.P. | 04/30/2020 | |
North Bridge Venture Management GP, LLC, /s/ Edward T. Anderson, Manager of NBVM GP | 04/30/2020 | |
North Bridge Venture Management VI, L.P., /s/ Edward T. Anderson, Manager of NBVM GP, general partner of North Bridge Venture Management VI, L.P. | 04/30/2020 | |
/s/ Richard A. D'Amore | 04/30/2020 | |
** 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. |