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.