0001628280-22-027125.txt : 20221026 0001628280-22-027125.hdr.sgml : 20221026 20221026200136 ACCESSION NUMBER: 0001628280-22-027125 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221024 FILED AS OF DATE: 20221026 DATE AS OF CHANGE: 20221026 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CRANDELL KEITH CENTRAL INDEX KEY: 0001219039 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41536 FILM NUMBER: 221334517 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD STREET 2: SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GILLIS STEVEN CENTRAL INDEX KEY: 0001229592 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41536 FILM NUMBER: 221334515 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD STREET 2: SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burow Kristina CENTRAL INDEX KEY: 0001569248 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41536 FILM NUMBER: 221334516 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD STREET 2: SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ARCH Venture Fund X, L.P. CENTRAL INDEX KEY: 0001757011 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41536 FILM NUMBER: 221334519 BUSINESS ADDRESS: STREET 1: 8755 W. HIGGINS ROAD, SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 BUSINESS PHONE: 773-380-6600 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD, SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ARCH Venture Fund X Overage, L.P. CENTRAL INDEX KEY: 0001757017 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41536 FILM NUMBER: 221334518 BUSINESS ADDRESS: STREET 1: 8755 W. HIGGINS ROAD, SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 BUSINESS PHONE: 773-380-6600 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD, SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ARCH Venture Partners X Overage, L.P. CENTRAL INDEX KEY: 0001768905 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41536 FILM NUMBER: 221334520 BUSINESS ADDRESS: STREET 1: 8755 W. HIGGINS ROAD, SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 BUSINESS PHONE: 773-380-6600 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD, SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ARCH Venture Partners X, LLC CENTRAL INDEX KEY: 0001769012 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41536 FILM NUMBER: 221334522 BUSINESS ADDRESS: STREET 1: 8755 W. HIGGINS ROAD, SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 BUSINESS PHONE: 773-380-6600 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD, SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ARCH Venture Partners X, L.P. CENTRAL INDEX KEY: 0001782583 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41536 FILM NUMBER: 221334521 BUSINESS ADDRESS: STREET 1: 8755 W. HIGGINS ROAD STREET 2: SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 BUSINESS PHONE: 7733806600 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD STREET 2: SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Prime Medicine, Inc. CENTRAL INDEX KEY: 0001894562 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 21 ERIE ST. CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 617-465-0013 MAIL ADDRESS: STREET 1: 21 ERIE ST. CITY: CAMBRIDGE STATE: MA ZIP: 02139 4 1 wf-form4_166682887797580.xml FORM 4 X0306 4 2022-10-24 0 0001894562 Prime Medicine, Inc. PRME 0001769012 ARCH Venture Partners X, LLC 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 0 0 1 0 0001782583 ARCH Venture Partners X, L.P. 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 0 0 1 0 0001768905 ARCH Venture Partners X Overage, L.P. 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 0 0 1 0 0001757011 ARCH Venture Fund X, L.P. 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 0 0 1 0 0001757017 ARCH Venture Fund X Overage, L.P. 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 0 0 1 0 0001219039 CRANDELL KEITH 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 0 0 1 0 0001569248 Burow Kristina 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 0 0 1 0 0001229592 GILLIS STEVEN 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 0 0 1 0 Common Stock 2022-10-24 4 C 0 5728297 A 5728297 I By ARCH Venture Fund X, L.P. Common Stock 2022-10-24 4 C 0 5728297 A 5728297 I By ARCH Venture Fund X Overage, L.P. Common Stock 2022-10-24 4 P 0 400000 17 A 6128297 I By ARCH Venture Fund X, L.P. Common Stock 2022-10-24 4 P 0 400000 17 A 6128297 I By ARCH Venture Fund X Overage, L.P. Series A Convertible Preferred Stock 2022-10-24 4 C 0 16666667 0 D Common Stock 5361122.0 0 I By ARCH Venture Fund X, L.P Series A Convertible Preferred Stock 2022-10-24 4 C 0 16666664 0 D Common Stock 5361122.0 0 I By ARCH Venture Fund X Overage, L.P. Series B Convertible Preferred Stock 2022-10-24 4 C 0 1141474 0 D Common Stock 367175.0 0 I By ARCH Venture Fund X, L.P. Series B Convertible Preferred Stock 2022-10-24 4 C 0 1141474 0 D Common Stock 367175.0 0 I By ARCH Venture Fund X Overage, L.P. The shares of Series A Convertible Preferred Stock and Series B Convertible Preferred Stock (together, the "Preferred Stock") were convertible into Common Stock on a one-for-3.10880 basis at any time at the option of the holder, and automatically converted into the number of shares shown in Column 7 immediately prior to the closing of the Issuer's initial public offering on October 24, 2022. The Preferred Stock had no expiration date. Represents shares held directly by ARCH Venture Fund X, L.P. ("ARCH X"). ARCH Venture Partners X, L.P. ("AVP X LP") is the sole general partner of ARCH X. ARCH Venture Partners X, LLC ("AVP X LLC") is the sole general partner of each of AVP X LP and AVP X Overage LP. Keith Crandell, Kristina Burow and Steven Gillis are members of the investment committee of AVP X LLC (the "AVP X Committee Members"). AVP X LP and AVP X Overage LP may be deemed to beneficially own the shares held by ARCH X and ARCH X Overage, respectively, AVP X LLC may be deemed to beneficially own the shares held by ARCH X and ARCH X Overage, and each of the AVP X Committee Members may be deemed to share the power to direct the disposition and vote of the shares held by ARCH X and ARCH X Overage. AVP X LP, AVP X Overage LP, AVP X LLC, and the AVP X Committee Members each disclaim beneficial ownership except to the extent of any pecuniary interest therein, and this report shall not be deemed an admission that such shares are beneficially owned by them for Section 16 or any other purpose. Represents shares held directly by ARCH Venture Fund X Overage, L.P. ("ARCH X Overage"). ARCH Venture Partners X Overage, L.P. ("AVP X Overage LP") is the sole general partner of ARCH X Overage. Reflects shares purchased by ARCH X in the Issuer's initial public offering. Reflects shares purchased by ARCH X Overage in the Issuer's initial public offering. /s/ ARCH Venture Fund X, L.P., By: ARCH Venture Partners X, L.P., its General Partner, By: ARCH Venture Partners X, LLC, its General Partner, By: Mark McDonnell, attorney-in-fact 2022-10-26 /s/ ARCH Venture Fund X Overage, L.P., By: ARCH Venture Partners X Overage, L.P., its General Partner, By: ARCH Venture Partners X, LLC, its General Partner, By: Mark McDonnell, attorney-in-fact 2022-10-26 /s/ ARCH Venture Partners X, L.P., By: ARCH Venture Partners X, LLC, its General Partner, By: Mark McDonnell, attorney-in-fact 2022-10-26 /s/ ARCH Venture Partners X Overage, L.P., By: ARCH Venture Partners X, LLC, its General Partner, By: Mark McDonnell, attorney-in-fact 2022-10-26 /s/ ARCH Venture Partners X, LLC, By: Mark McDonnell, attorney-in-fact 2022-10-26 /s/ Keith Crandell, By: Mark McDonnell, attorney-in-fact 2022-10-26 /s/ Kristina Burow, By: Mark McDonnell, attorney-in-fact 2022-10-26 /s/ Steven Gillis, By: Mark McDonnell, attorney-in-fact 2022-10-26