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) 03/01/2022 |
3. Issuer Name and Ticker or Trading Symbol
Global Blood Therapeutics, Inc. [ GBT ] |
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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) |
Common Stock | 27,960 | D |
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) | 02/08/2026 | Common Stock | 23,597 | $12.95 | D | |
Stock Option (Right to buy) | (2) | 02/28/2027 | Common Stock | 9,000 | $29.75 | D | |
Stock Option (Right to buy) | (3) | 01/31/2028 | Common Stock | 8,000 | $59.6 | D | |
Stock Option (Right to buy) | (4) | 01/31/2029 | Common Stock | 5,475 | $48.44 | D | |
Restricted Stock Units | (5) | (5) | Common Stock | 1,875 | (6) | D | |
Stock Option (Right to buy) | (7) | 09/30/2029 | Common Stock | 8,000 | $46.99 | D | |
Restricted Stock Units | (8) | (8) | Common Stock | 5,500 | (6) | D | |
Stock Option (Right to buy) | (9) | 02/02/2030 | Common Stock | 3,724 | $65.82 | D | |
Restricted Stock Units | (10) | (10) | Common Stock | 2,327 | (6) | D | |
Stock Option (Right to buy) | (11) | 03/31/2030 | Common Stock | 2,329 | $48.73 | D | |
Restricted Stock Units | (12) | (12) | Common Stock | 913 | (6) | D | |
Restricted Stock Units | (13) | (13) | Common Stock | 6,300 | (6) | D | |
Stock Option (Right to buy) | (14) | 02/28/2031 | Common Stock | 23,424 | $44.48 | D | |
Restricted Stock Units | (15) | (15) | Common Stock | 11,694 | (6) | D |
Explanation of Responses: |
1. The shares of Common Stock underlying the stock option vested as to 25% of the original grant for 30,000 shares on January 11, 2017 and in 12 equal quarterly installments thereafter through January 11, 2020. |
2. The shares of Common Stock underlying the stock option vested in 16 quarterly installments after February 1, 2017 through February 1, 2021. |
3. The shares of Common Stock underlying the stock option vested in 16 quarterly installments after March 1, 2018 through March 1, 2022. |
4. The shares of Common Stock underlying the stock option vest in 16 quarterly installments after February 1, 2019 through February 1, 2023, subject to the Reporting Person's continuous service with the Issuer through each vesting date. The option is subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
5. The shares of Common Stock underlying the original grant of 7,500 Restricted Stock Units ("RSUs") vest in eight semi-annual installments after February 1, 2019 through February 1, 2023, subject to the Reporting Person's continuous service with the Issuer through each vesting date, and have no expiration date. The RSUs are subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
6. Each RSU represents a contingent right to receive one share of the Issuer's Common Stock. |
7. The shares of Common Stock underlying the stock option vest in 16 quarterly installments after October 1, 2019 through October 1, 2023, subject to the Reporting Person's continuous service with the Issuer through each vesting date. The option is subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
8. The shares of Common Stock underlying the original grant of 11,000 RSUs vest in eight semi-annual installments after October 1, 2019 through October 1, 2023, subject to the Reporting Person's continuous service with the Issuer through each vesting date, and have no expiration date. The RSUs are subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
9. The shares of Common Stock underlying the stock option vest in 16 quarterly installments after February 1, 2020 through February 1, 2024, subject to the Reporting Person's continuous service with the Issuer through each vesting date. The option is subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
10. The shares of Common Stock underlying the original grant of 4,655 RSUs vest in eight semi-annual installments after February 1, 2020 through February 1, 2024, subject to the Reporting Person's continuous service with the Issuer through each vesting date, and have no expiration date. The RSUs are subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
11. The shares of Common Stock underlying the stock option vest in 16 quarterly installments after April 1, 2020 through April 1, 2024, subject to the Reporting Person's continuous service with the Issuer through each vesting date. The option is subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
12. The shares of Common Stock underlying the original grant of 1,461 RSUs vest in eight semi-annual installments after April 1, 2020 through April 1, 2024, subject to the Reporting Person's continuous service with the Issuer through each vesting date, and have no expiration date. The RSUs are subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
13. The shares of Common Stock underlying the RSUs vest in installments conditioned upon the achievement, on or before June 30, 2024, of up to three specified market price thresholds of the Issuer, subject to the Reporting Person's continuous service with the Issuer through each vesting date. The RSUs are subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
14. The shares of Common Stock underlying the stock option vests in 16 quarterly installments after March 1, 2021 through March 1, 2025, subject to the Reporting Person's continuous service with the Issuer through each vesting date. The option is subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
15. The shares of Common Stock underlying the original grant of 13,364 RSUs vest in eight semi-annual installments after March 1, 2021 through March 1, 2025, subject to the Reporting Person's continuous service with the Issuer through each vesting date, and have no expiration date. The RSUs are subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
Remarks: |
Executive Vice President, Operations Exhibit 24.1 - Power of Attorney |
/s/ Miguel Carrillo, Attorney-in-Fact | 03/03/2022 | |
** 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. |