0001209191-19-038119.txt : 20190619 0001209191-19-038119.hdr.sgml : 20190619 20190619182524 ACCESSION NUMBER: 0001209191-19-038119 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20190619 FILED AS OF DATE: 20190619 DATE AS OF CHANGE: 20190619 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hefti Franz CENTRAL INDEX KEY: 0001735529 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38939 FILM NUMBER: 19907078 MAIL ADDRESS: STREET 1: C/O ALZHEON, INC. STREET 2: 111 SPEEN STREET, SUITE 306 CITY: FRAMINGHAM STATE: MA ZIP: 01701 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Prevail Therapeutics Inc. CENTRAL INDEX KEY: 0001714798 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 430 EAST 29TH STREET, SUITE 940 CITY: NEW YORK STATE: NY ZIP: 10016 BUSINESS PHONE: 917-336-9310 MAIL ADDRESS: STREET 1: 430 EAST 29TH STREET, SUITE 940 CITY: NEW YORK STATE: NY ZIP: 10016 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2019-06-19 0 0001714798 Prevail Therapeutics Inc. PRVL 0001735529 Hefti Franz C/O PREVAIL THERAPEUTICS INC. 430 EAST 29TH STREET, SUITE 940 NEW YORK NY 10016 0 1 0 0 Chief Development Officer Stock Option (Right to Buy) 0.18 2028-03-05 Common Stock 266895 D Stock Option (Right to Buy) 10.26 2029-04-24 Common Stock 59844 D 25% of the total number of shares underlying the option vested and became exercisable on March 7, 2019 and an additional 1/48th of the total number of shares underlying the option shall vest and become exercisable on the first day of each of the thirty-six (36) consecutive months thereafter subject, in all cases, to the Reporting Person providing continuous service with the Issuer on each such date. 25% of the total number of shares underlying the option shall vest and become exercisable on April 24, 2020 and an additional 1/48th of the total number of shares underlying the option shall vest and become exercisable on the same date of each of the thirty-six (36) consecutive months thereafter subject, in all cases, to the Reporting Person providing continuous service with the Issuer on each such date. Exhibit List - Exhibit 24 - Power of Attorney No Table I Securities Beneficially Owned /s/ Alison Haggerty, Attorney-in-Fact 2019-06-19 EX-24.3_861147 2 poa.txt POA DOCUMENT POWER OF ATTORNEY (For Executing Form ID and Forms 3, 4 and 5) Know all by these presents, that the undersigned hereby constitutes and appoints Divikar Gupta and Alison Haggerty of Cooley LLP and Brett Kaplan and Asa Abeliovich of Prevail Therapeutics Inc. (the "Company"), signing individually, as the undersigned's true and lawful attorneys-in fact and agents to: (1) Prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the Securities and Exchange Commission (the "SEC") Form ID and Forms 3, 4 and 5 (including amendments thereto and joint filing agreements in connection therewith) in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act") and the rules thereunder in the undersigned's capacity as an officer, director or beneficial owner of more than 10% of a registered class of securities of the Company; (2) Do and perform any and all acts for and on behalf of the undersigned that may be necessary or desirable to prepare and execute any such Form ID or Forms 3, 4 or 5 (including amendments thereto and joint filing agreements in connection therewith) and file such forms with the SEC and any stock exchange, self-regulatory association or any similar authority; and (3) Take any other action of any type whatsoever in connection with the foregoing that, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required of the undersigned, it being understood that the documents executed by the attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as the attorney-in-fact may approve in the attorney-in-fact's discretion. The undersigned hereby grants to each such attorney in fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney in fact, or such attorney in fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, and their substitutes, in serving in such capacity at the request of the undersigned, are not assuming (nor is the Company assuming) any of the undersigned's responsibilities to comply with Section 16 of the Exchange Act. This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) the undersigned is no longer required to file Form ID or Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, (b) revocation by the undersigned in a signed writing delivered to the Company and the foregoing attorneys-in fact or (c) as to any attorney-in-fact individually, until such attorney-in-fact is no longer an employee of the Company or employed by Cooley LLP, as applicable. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of the date written below. Date: May 31, 2019 By: /s/ Franz Hefti Franz Hefti, Ph.D.