0001209191-20-051065.txt : 20200917 0001209191-20-051065.hdr.sgml : 20200917 20200917203505 ACCESSION NUMBER: 0001209191-20-051065 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20200917 FILED AS OF DATE: 20200917 DATE AS OF CHANGE: 20200917 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: EDELMAN JOSEPH CENTRAL INDEX KEY: 0001164426 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39503 FILM NUMBER: 201182482 MAIL ADDRESS: STREET 1: C/O PERCEPTIVE ADVISORS LLC STREET 2: 51 ASTOR PLACE, 10TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10003 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Athira Pharma, Inc. CENTRAL INDEX KEY: 0001620463 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4000 MASON ROAD, SUITE 300 STREET 2: BOX 352141 CITY: SEATTLE STATE: WA ZIP: 981952141 BUSINESS PHONE: 5095927191 MAIL ADDRESS: STREET 1: 4000 MASON ROAD, SUITE 300 STREET 2: BOX 352141 CITY: SEATTLE STATE: WA ZIP: 981952141 FORMER COMPANY: FORMER CONFORMED NAME: M3 Biotechnology, Inc. DATE OF NAME CHANGE: 20140924 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2020-09-17 0 0001620463 Athira Pharma, Inc. ATHA 0001164426 EDELMAN JOSEPH C/O ATHIRA PHARMA, INC. 4000 MASON ROAD, SUITE 300 SEATTLE WA 98195 1 0 1 0 Common Stock 411196 I See Footnote Series B Preferred Stock Common Stock 1644785 I See Footnote Stock Option (Right to Buy) 17.00 2030-09-16 Common Stock 27742 D Reflects a 7.9302-for-1 reverse stock split of the outstanding shares of the Issuer effected September 11, 2020. The securities are directly held by Perceptive Life Sciences Master Fund Ltd. (the "Master Fund"). Perceptive Advisors LLC (the "Advisor") serves as the investment manager of Master Fund. Joseph Edelman is the managing member of the Advisor. Mr. Edelman disclaims, for purposes of Section 16 of the Securities Exchange Act of 1934, beneficial ownership of such securities, except to the extent of his indirect pecuniary interest therein, and this report shall not be deemed an admission that Mr. Edelman is the beneficial owner of such securities for purposes of Section 16 or for any other purposes. The Series B Preferred Stock is convertible into shares of the Issuers Common Stock on a 1-for-1 basis, and will automatically convert to shares of the Issuers Common Stock upon the closing of the Issuers initial public offering on a 1-for-1 basis. These shares have no expiration date. One-thirty-sixth of the shares subject to the option will vest on October 17, 2020 and one-thirty-sixth of the shares subject to the option will vest each month thereafter. Glenna Mileson, Attorney in fact for Joseph Edelman 2020-09-17 EX-24.3_937726 2 poa.txt POA DOCUMENT POWER OF ATTORNEY The undersigned, as a Section 16 reporting person of Athira Pharma, Inc. (the Company), hereby constitutes and appoints Glenna Mileson, Barbara Mery and each of the responsible attorneys and paralegals of Wilson Sonsini Goodrich & Rosati, Professional Corporation, the undersigneds true and lawful attorney-in-fact to: 1. complete and execute Forms ID, 3,4 and 5 and other forms and all amendments thereto as such attorney-in-fact shall in his or her discretion determine to be required or advisable pursuant to Section 16 of the Securities Exchange Act of 1934 (as amended) and the rules and regulations promulgated thereunder, or any successor laws and regulations, as a consequence of the undersigneds ownership, acquisition or disposition of securities of the Company; and 2. do all acts necessary in order to file such forms with the Securities and Exchange Commission, any securities exchange or national association, the Company and such other person or agency as the attorney-in-fact shall deem appropriate. The undersigned hereby ratifies and confirms all that said attorneys-in-fact and agents shall do or cause to be done by virtue hereof. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigneds responsibilities to comply with Section 16 of the Securities Exchange Act of 1934 (as amended). This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms ID, 3, 4 and 5 with respect to the undersigneds holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the Company and the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of August 18, 2020. . Signature: /s/ Joseph Edelman Joseph Edelman