0001209191-22-001651.txt : 20220105 0001209191-22-001651.hdr.sgml : 20220105 20220105161528 ACCESSION NUMBER: 0001209191-22-001651 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220103 FILED AS OF DATE: 20220105 DATE AS OF CHANGE: 20220105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hicks Derek CENTRAL INDEX KEY: 0001901282 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37766 FILM NUMBER: 22511309 MAIL ADDRESS: STREET 1: C/O INTELLIA THERAPEUTICS, INC. STREET 2: 40 ERIE STREET SUITE 130 CITY: CAMBRIDGE STATE: MA ZIP: 02139 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Intellia Therapeutics, Inc. CENTRAL INDEX KEY: 0001652130 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 364785571 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 40 ERIE STREET STREET 2: SUITE 130 CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 857-285-6200 MAIL ADDRESS: STREET 1: 40 ERIE STREET STREET 2: SUITE 130 CITY: CAMBRIDGE STATE: MA ZIP: 02139 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-01-03 0 0001652130 Intellia Therapeutics, Inc. NTLA 0001901282 Hicks Derek C/O INTELLIA THERAPEUTICS, INC. 40 ERIE STREET CAMBRIDGE MA 02139 0 1 0 0 EVP, Chief Business Officer Common Stock 2022-01-03 4 A 0 19118 0.00 A 19118 D Stock option (right to buy) 118.99 2022-01-03 4 A 0 25000 0.00 A 2032-01-02 Common Stock 25000 25000 D Based on a grant of restricted stock units representing a contingent right to receive one share of Intellia common stock for each restricted stock unit. This option was granted on January 3, 2022 with respect to 25,000 shares of Common Stock pursuant to the Intellia Therapeutics, Inc. Amended and Restated 2015 Stock Option and Incentive Plan, with 25% vesting on December 20, 2022 and the remaining 75% vesting in thirty-six (36) substantially equal monthly installments thereafter. /s/ James Basta, Attorney-in-fact 2022-01-05