0001209191-22-056302.txt : 20221109 0001209191-22-056302.hdr.sgml : 20221109 20221109203016 ACCESSION NUMBER: 0001209191-22-056302 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20221109 FILED AS OF DATE: 20221109 DATE AS OF CHANGE: 20221109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Holm-Jorgensen Rasmus CENTRAL INDEX KEY: 0001950496 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41551 FILM NUMBER: 221374536 MAIL ADDRESS: STREET 1: C/O ACRIVON THERAPEUTICS, INC. STREET 2: 480 ARSENAL WAY, SUITE 100 CITY: WATERTOWN STATE: MA ZIP: 02472 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Acrivon Therapeutics, Inc. CENTRAL INDEX KEY: 0001781174 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 825125532 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 480 ARSENAL WAY, SUITE 100 CITY: WATERTOWN STATE: MA ZIP: 02472 BUSINESS PHONE: 617-207-8979 MAIL ADDRESS: STREET 1: 480 ARSENAL WAY, SUITE 100 CITY: WATERTOWN STATE: MA ZIP: 02472 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2022-11-09 0 0001781174 Acrivon Therapeutics, Inc. ACRV 0001950496 Holm-Jorgensen Rasmus C/O ACRIVON THERAPEUTICS, INC. 480 ARSENAL WAY, SUITE 100 WATERTOWN MA 02472 0 1 0 0 Chief Financial Officer Stock Option (Right to Buy) 3.63 2032-06-28 Common Stock 192619 D Twenty-five percent (25%) of the shares subject to the option shall vest on April 20, 2023, and the remaining shares subject to the option shall vest in 12 equal quarterly installments thereafter, in each case subject to the Reporting Person's continuous service through each such vesting date. Exhibit List - Exhibit 24 - Power of Attorney /s/ Rasmus Holm-Jorgensen 2022-11-09 EX-24 2 poa.txt POA DOCUMENT Exhibit 24 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 each of Ryan Sansom, Mark Ballantyne, Katherine Denby, David Brinton, Chrystal Cantrelle, Bella Gelin and Albert Gelin of Cooley LLP, and Peter Blume-Jensen, Eric Devroe and Katharine Peterson of Acrivon Therapeutics, Inc. (the "Company"), signing individually, 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 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 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 employed by the Company or 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: October 7, 2022 By: /s/ Rasmus Holm-Jorgensen Name: Rasmus Holm-Jorgensen