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