FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 09/17/2020 |
3. Issuer Name and Ticker or Trading Symbol
Athira Pharma, Inc. [ ATHA ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option (Right to Buy)(1) | (2) | 12/17/2028 | Common Stock | 12,610 | $1.35 | D | |
Stock Option (Right to Buy)(1) | (3) | 12/17/2028 | Common Stock | 12,610 | $1.35 | D | |
Stock Option (Right to Buy)(1) | (4) | 06/25/2029 | Common Stock | 25,220 | $1.35 | D | |
Stock Option (Right to Buy)(1) | (5) | 01/28/2030 | Common Stock | 31,525 | $1.35 | D | |
Stock Option (Right to Buy)(1) | (6) | 09/16/2030 | Common Stock | 27,742 | $17 | D |
Explanation of Responses: |
1. Reflects a 7.9302-for-1 reverse stock split of the outstanding shares of the Issuer effected September 11, 2020. |
2. The shares subject to the option fully vested on June 19, 2020. |
3. One-half of the shares subject to the option vested on January 1, 2020 and one-half of the shares subject to the option vest on each year thereafter. |
4. One-third of the shares subject to the option vested on June 26, 2020 and one-thirty-sixth of the shares subject to the option will vest on each month thereafter. |
5. One-third of the shares subject to the option will vest on December 13, 2020 and one-thirty-sixth of the shares subject to the option will vest on each month thereafter. |
6. 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. |
Remarks: |
Glenna Mileson, Attorney in fact for Tadataka Yamada | 09/17/2020 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |