0000899243-23-004990.txt : 20230214
0000899243-23-004990.hdr.sgml : 20230214
20230214163532
ACCESSION NUMBER: 0000899243-23-004990
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221231
FILED AS OF DATE: 20230214
DATE AS OF CHANGE: 20230214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MILNE GEORGE M JR
CENTRAL INDEX KEY: 0001179552
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41199
FILM NUMBER: 23630403
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Amylyx Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001658551
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 464600503
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 43 THORNDIKE STREET
CITY: CAMBRIDGE
STATE: MA
ZIP: 02141
BUSINESS PHONE: 617-683-0917
MAIL ADDRESS:
STREET 1: 43 THORNDIKE STREET
CITY: CAMBRIDGE
STATE: MA
ZIP: 02141
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2022-12-31
0
0
1
0001658551
Amylyx Pharmaceuticals, Inc.
AMLX
0001179552
MILNE GEORGE M JR
C/O AMYLYX PHARMACEUTICALS, INC.
43 THORNDIKE STREET
CAMBRIDGE
MA
02141
1
0
0
0
Common Stock
2022-01-06
4
C
0
689425
A
910821
D
Common Stock
2022-12-29
5
G
0
13800
0.00
D
897021
D
Series A Preferred Stock
2022-01-06
4
C
0
262282
0.00
D
Common Stock
262282
0
D
Series B Preferred Stock
2022-01-06
4
C
0
384449
0.00
D
Common Stock
384449
0
D
Series C-1 Preferred Stock
2022-01-06
4
C
0
19482
0.00
D
Common Stock
19482
0
D
Series C-2 Preferred Stock
2022-01-06
4
C
0
23212
0.00
D
Common Stock
23212
0
D
Upon the closing of the Issuer's initial public offering, all shares of Series A, Series B, Series C-1 and Series C-2 Preferred Stock (the "Preferred Stock") automatically converted into the number of shares of the Issuer's Common Stock shown in column 4 of Table I without payment or further consideration. The Preferred Stock had no expiration date.
/s/ Joshua B. Cohen, as Attorney-in-Fact
2023-02-14