0001209191-18-054454.txt : 20181005 0001209191-18-054454.hdr.sgml : 20181005 20181005194418 ACCESSION NUMBER: 0001209191-18-054454 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180926 FILED AS OF DATE: 20181005 DATE AS OF CHANGE: 20181005 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: POTTER MYRTLE S CENTRAL INDEX KEY: 0001214130 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37418 FILM NUMBER: 181111674 MAIL ADDRESS: STREET 1: 10 FINDERNE AVE CITY: BRIDGEWATER STATE: NJ ZIP: 08807 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Axovant Sciences Ltd. CENTRAL INDEX KEY: 0001636050 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: D0 FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 20-22 BEDFORD ROW CITY: LONDON STATE: X0 ZIP: WC1R 4JS BUSINESS PHONE: 441-295-5950 MAIL ADDRESS: STREET 1: 20-22 BEDFORD ROW CITY: LONDON STATE: X0 ZIP: WC1R 4JS FORMER COMPANY: FORMER CONFORMED NAME: Axovant Sciences, Inc. DATE OF NAME CHANGE: 20150324 FORMER COMPANY: FORMER CONFORMED NAME: Roivant Neurosciences Ltd. DATE OF NAME CHANGE: 20150309 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-09-26 1 0001636050 Axovant Sciences Ltd. AXON 0001214130 POTTER MYRTLE S C/O AXOVANT SCIENCES INC. 11 TIMES SQUARE, 33RD FLOOR NEW YORK NY 10036 1 0 0 0 /s/ John T. McKenna, Attorney-in-Fact 2018-10-05 EX-24.3_812999 2 poa.txt POA DOCUMENT AXOVANT SCIENCES LTD. POWER OF ATTORNEY (For Executing Form ID and Forms 3, 4 and 5) Know all by these presents, that the undersigned hereby constitutes and appoints each of John McKenna, Frank Rahmani, Milson Yu and Alison Haggerty of Cooley LLP, and Guled Adam and Mathew Bazley of Axovant Sciences, Inc. the undersigned's true and lawful attorneys-in-fact and agents to: 1. Prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the Securities and Exchange Commission (the "SEC') Form ID, Uniform Application for Access Codes to File on EDGAR, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act'), or any rule or regulation thereunder; 2. Prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the SEC Forms 3, 4 and 5 (including amendments thereto and joint filing agreements in connection therewith) in accordance with Section 16(a) of the Exchange Act and the rules and regulations thereunder in the undersigned's capacity as an officer, director or beneficial owner of more than I 0% of a registered class of securities of Axovant Sciences Ltd. (the "Company"); 3. Do and perform any and all acts for and on behalf of the undersigned that may be necessary or desirable to execute such Forms 3, 4, or 5, or Form ID (including any amendments thereto) and timely file such forms with the SEC, and any stock exchange, self-regulatory association or similar authority; and 4. Take any other action of any nature whatsoever in connection with the foregoing that, in the opinion of such attorney-in-fact, may be of benefit, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned acknowledges that: The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, and their substitutes, in serving in such capacity at the request of the undersigned, are not assuming (nor is the Company assuming) any of the undersigned's responsibilities to comply with Section 16 of the Exchange Act. This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, (b) revocation by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact or (c) as to any attorney-in-fact individually, until such attorney-in-fact is no longer employed by Cooley LLP, Axovant Sciences, Inc. or of Roivant Sciences, Inc. or another subsidiary of the Company, as applicable. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of the date written below. Dated: October 4, 2018 /s/ Myrtle S. Potter