0001209191-19-043052.txt : 20190724 0001209191-19-043052.hdr.sgml : 20190724 20190724165116 ACCESSION NUMBER: 0001209191-19-043052 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190722 FILED AS OF DATE: 20190724 DATE AS OF CHANGE: 20190724 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: New Enterprise Associates 16, L.P. CENTRAL INDEX KEY: 0001694560 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38981 FILM NUMBER: 19971541 BUSINESS ADDRESS: STREET 1: 1954 GREENSPRING DRIVE STREET 2: SUITE 600 CITY: TIMONIUM STATE: MD ZIP: 21093 BUSINESS PHONE: 410-842-4000 MAIL ADDRESS: STREET 1: 1954 GREENSPRING DRIVE STREET 2: SUITE 600 CITY: TIMONIUM STATE: MD ZIP: 21093 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NEA Partners 16, L.P. CENTRAL INDEX KEY: 0001712881 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38981 FILM NUMBER: 19971542 BUSINESS ADDRESS: STREET 1: 1954 GREENSPRING DRIVE, SUITE 600 CITY: TIMONIUM STATE: MD ZIP: 21093 BUSINESS PHONE: 410-842-4000 MAIL ADDRESS: STREET 1: 1954 GREENSPRING DRIVE, SUITE 600 CITY: TIMONIUM STATE: MD ZIP: 21093 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NEA 16 GP, LLC CENTRAL INDEX KEY: 0001712882 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38981 FILM NUMBER: 19971543 BUSINESS ADDRESS: STREET 1: 1954 GREENSPRING DRIVE, SUITE 600 CITY: TIMONIUM STATE: MD ZIP: 21093 BUSINESS PHONE: 410-842-4000 MAIL ADDRESS: STREET 1: 1954 GREENSPRING DRIVE, SUITE 600 CITY: TIMONIUM STATE: MD ZIP: 21093 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Mirum Pharmaceuticals, Inc. CENTRAL INDEX KEY: 0001759425 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 831281555 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 950 TOWER LANE, SUITE 1050 CITY: FOSTER CITY STATE: CA ZIP: 94404 BUSINESS PHONE: 650-667-4085 MAIL ADDRESS: STREET 1: 950 TOWER LANE, SUITE 1050 CITY: FOSTER CITY STATE: CA ZIP: 94404 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-07-22 0 0001759425 Mirum Pharmaceuticals, Inc. MIRM 0001694560 New Enterprise Associates 16, L.P. 1954 GREENSPRING DRIVE SUITE 600 TIMONIUM MD 21093 0 0 1 0 0001712881 NEA Partners 16, L.P. 1954 GREENSPRING DRIVE SUITE 600 TIMONIUM MD 21093 0 0 1 0 0001712882 NEA 16 GP, LLC 1954 GREENSPRING DRIVE SUITE 600 TIMONIUM MD 21093 0 0 1 0 Common Stock 2019-07-22 4 C 0 3736243 A 3736243 D Common Stock 2019-07-22 4 P 0 450000 15.00 A 4186243 D Series A Preferred Stock 2019-07-22 4 C 0 29889945 0.00 D Common Stock 3736243 0 D Automatic conversion, in connection with the Issuer's initial public offering, of each share of the Issuer's Series A preferred stock into 0.125 shares of the Issuer's common stock. The shares have no expiration date. The shares are directly held by New Enterprise Associates 16, L.P. ("NEA 16"), and indirectly held by NEA Partners 16, L.P. ("NEA Partners"), the sole general partner of NEA 16, NEA 16 GP, LLC ("NEA 16 GP"), the sole general partner of NEA Partners 16, and the individual managers of NEA 16 GP (NEA Partners 16, NEA 16 GP and the individual managers of NEA 16 GP, together, the "Indirect Reporting Persons").The individual managers of NEA 16 GP are Peter J. Barris, Forest Baskett, Ali Behbahani, Carmen Chang, Anthony A. Florence, Jr., Mohamad Makhzoumi, Josh Makower, David M. Mott, Scott D. Sandell, Peter W. Sonsini and Paul Walker. The Indirect Reporting Persons disclaim beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the shares of the Issuer held by NEA 16 in which the Indirect Reporting Persons have no pecuniary interest. The shares were purchased in the Issuer's initial public offering. /s/ Sasha Keough, attorney-in-fact 2019-07-24