0001104659-16-163804.txt : 20161223
0001104659-16-163804.hdr.sgml : 20161223
20161223180239
ACCESSION NUMBER: 0001104659-16-163804
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161018
FILED AS OF DATE: 20161223
DATE AS OF CHANGE: 20161223
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CRISPR Therapeutics AG
CENTRAL INDEX KEY: 0001674416
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 473173478
STATE OF INCORPORATION: V8
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: AESCHENVORSTADT 36
CITY: BASEL
STATE: V8
ZIP: 4051
BUSINESS PHONE: 6173154600
MAIL ADDRESS:
STREET 1: AESCHENVORSTADT 36
CITY: BASEL
STATE: V8
ZIP: 4051
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bolzon Bradley J PhD
CENTRAL INDEX KEY: 0001354345
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37923
FILM NUMBER: 162069510
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
4
1
a4.xml
4
X0306
4
2016-10-18
0
0001674416
CRISPR Therapeutics AG
CRSP
0001354345
Bolzon Bradley J PhD
C/O CRISPR THERAPEUTICS, INC.,
200 SIDNEY STREET
CAMBRIDGE
MA
02139
1
0
0
0
Common Stock
684014
I
See footnote
Common Stock
2016-10-24
4
C
0
437247
A
676895
I
See footnote
Common Stock
2016-10-24
4
C
0
3100477
A
3777372
I
See footnote
Common Stock
2016-10-24
4
C
0
231077
A
4008449
I
See footnote
Common Stock
2016-10-24
4
P
0
95596
14.00
A
4104045
I
See footnote
Common Stock
2016-10-24
4
C
0
2754
A
2754
I
See footnote
Common Stock
2016-10-24
4
C
0
19524
A
22278
I
See footnote
Common Stock
2016-10-24
4
C
0
1454
A
23732
I
See footnote
Common Stock
2016-10-24
4
P
0
602
14.00
A
24334
I
See footnote
Common Stock
2016-10-24
4
C
0
2210417
A
2210417
I
See footnote
Common Stock
2016-10-24
4
C
0
173167
A
2383584
I
See footnote
Common Stock
2016-10-24
4
P
0
60219
14.00
A
2443803
I
See footnote
Common Stock
2016-10-24
4
C
0
66490
A
66490
I
See footnote
Common Stock
2016-10-24
4
C
0
5210
A
71700
I
See footnote
Common Stock
2016-10-24
4
C
0
168224
A
168224
I
See footnote
Common Stock
2016-10-24
4
C
0
13180
A
181404
I
See footnote
Common Stock
2016-10-24
4
P
0
4583
14.00
A
185987
I
See footnote
Common Stock
2016-10-24
4
C
0
73704
A
73704
I
See footnote
Common Stock
2016-10-24
4
C
0
5774
A
79478
I
See footnote
Stock Option (Right to Buy)
14.00
2016-10-18
4
A
0
30000
0
A
2026-10-18
Common Stock
30000
60000
I
See footnote
Series A-1 Preferred Shares
2016-10-24
4
C
0
437247
D
Common Stock
437247
0
I
See footnote
Series A-1 Preferred Shares
2016-10-24
4
C
0
2754
D
Common Stock
2754
0
I
See footnote
Series A-2 Preferred Shares
2016-10-24
4
C
0
3100477
D
Common Stock
3100477
0
I
See footnote
Series A-2 Preferred Shares
2016-10-24
4
C
0
19524
D
Common Stock
19524
0
I
See footnote
Series A-3 Preferred Shares
2016-10-24
4
C
0
2210417
D
Common Stock
2210417
0
I
See footnote
Series A-3 Preferred Shares
2016-10-24
4
C
0
66490
D
Common Stock
66490
0
I
See footnote
Series A-3 Preferred Shares
2016-10-24
4
C
0
168224
D
Common Stock
168224
0
I
See footnote
Series A-3 Preferred Shares
2016-10-24
4
C
0
73704
D
Common Stock
73704
0
I
See footnote
Series B Preferred Shares
2016-10-24
4
C
0
231077
D
Common Stock
231077
0
I
See footnote
Series B Preferred Shares
2016-10-24
4
C
0
1454
D
Common Stock
1454
0
I
See footnote
Series B Preferred Shares
2016-10-24
4
C
0
173167
D
Common Stock
173167
0
I
See footnote
Series B Preferred Shares
2016-10-24
4
C
0
5210
D
Common Stock
5210
0
I
See footnote
Series B Preferred Shares
2016-10-24
4
C
0
13180
D
Common Stock
13180
0
I
See footnote
Series B Preferred Shares
2016-10-24
4
C
0
5774
D
Common Stock
5774
0
I
See footnote
Each of the Reporting Person and Thomas Woiwode are managing members of Versant Venture Management, LLC. One-half of these shares were issued to the Reporting Person and one-half of these shares were issued to Mr. Woiwode, in each case, as compensation for service on the Issuer's board of directors. Pursuant to agreements with Versant Venture Management, LLC, the Reporting Person and Mr. Woiwode are deemed to hold these securities for the benefit of Versant Venture Management, LLC. Accordingly, Versant Venture Management, LLC may be deemed to be the indirect beneficial owner of these securities, and the Reporting Person may be deemed to indirectly beneficial own the securities through his interest in Versant Venture Management, LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
Each share of the Issuer's Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock and Series B Preferred Stock automatically converted into 1 share of the Issuer's Common Stock in its firm commitment initial public offering pursuant to the Issuer's prospectus (Form 424B4) filed with the Securities and Exchange Commission on October 19, 2016.
These securities are held of record by Versant Venture Capital IV, L.P. ("VVC IV"). Versant Ventures IV, LLC ("VV IV") is the sole general partner of VVC IV and may be deemed to have voting and investment power over the securities held by VVC IV and as a result may be deemed to have beneficial ownership over such securities. The Reporting Person is a managing director of VV IV and may be deemed to indirectly beneficially own the securities through his interest in VV IV. The Reporting Person disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
These securities are held of record by Versant Side Fund IV, L.P. ("VSF IV"). VV IV is the sole general partner of VSF IV and may be deemed to have voting and investment power over the securities held by VSF IV and as a result may be deemed to have beneficial ownership over such securities. The Reporting Person is a managing director of VV IV and may be deemed to indirectly beneficially own the securities through his interest in VV IV. The Reporting Person disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
These securities are held of record by Versant Venture Capital V, L.P. ("VVC V"). Versant Ventures V, LLC ("VV V") is the sole general partner of VVC V and may be deemed to have voting and investment power over the securities held by VVC V and as a result may be deemed to have beneficial ownership over such securities. The Reporting Person is a managing director of VV V and may be deemed to indirectly beneficially own the securities through his interest in VV V. The Reporting Person disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
These securities are held of record by Versant Affiliates Fund V, L.P. ("VAF V"). VV V is the sole general partner of VAF V and may be deemed to have voting and investment power over the securities held by VAF V and as a result may be deemed to have beneficial ownership over such securities. The Reporting Person is a managing director of VV V and may be deemed to indirectly beneficially own the securities through his interest in VV V. The Reporting Person disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
These securities are held of record by Versant Venture Capital V (Canada) LP ("VVC CAN"). Versant Ventures V (Canada) GP-GP, Inc. ("VV V CAN GP") is the sole general partner of Versant Ventures V (Canada), L.P. ("VV V CAN") and VV V CAN is the sole general partner of VVC CAN. VV V CAN GP and VV V CAN may be deemed to have voting and investment power over the securities held by VVC CAN and as a result may be deemed to have beneficial ownership over such securities. The Reporting Person is a director of VV V CAN GP and may be deemed to indirectly beneficially own the shares through his interest in VV V CAN GP. The Reporting Person disclaims beneficial ownership of these shares, except to the extent of his pecuniary interest therein, if any.
These securities are held of record by Versant Ophthalmic Affiliates Fund I, L.P. ("VOA"). VV V is the sole general partner of VOA and may be deemed to have voting and investment power over the securities held by VOA and as a result may be deemed to have beneficial ownership over such securities. The Reporting Person is a managing director of VV V and may be deemed to indirectly beneficially own the securities through his interest in VV V. The Reporting Person disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
The option grant reported hereby was made to Thomas Woiwode as compensation for services on the Issuer's board of directors. One-half of the securities held after the reported transaction, as reported in column 9, are held by the Reporting Person (the grant of which was previously reported by the Reporting Person) and one-half of the reported securities are held by Mr. Woiwode. Pursuant to the agreements described in footnote (1), the Reporting Person and Mr. Woiwode are deemed to hold these securities for the benefit of Versant Venture Management, LLC. Accordingly, Versant Venture Management, LLC may be deemed to be the indirect beneficial owner of these securities, and the Reporting Person may be deemed to indirectly beneficially own the securities through his interest in Versant Venture Management, LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
This option was granted on October 18, 2016 with respect to 30,000 Common Shares with 100% of the shares vesting in 36 equal monthly installments beginning October 31, 2016.
This Form 4 is being filed solely to report the grant of an option on October 18, 2016 in which the Reporting Person has an indirect beneficial interest, as well as the conversion of preferred stock into common stock that occurred upon the closing of the Issuer's initial public offering ("IPO") and the purchase of shares in the IPO, in each case on October 24, 2016, and not to report any other transactions in securities of the Issuer.
Bradley J. Bolzon, PhD
2016-12-23