0000905148-22-000390.txt : 20220513 0000905148-22-000390.hdr.sgml : 20220513 20220513163951 ACCESSION NUMBER: 0000905148-22-000390 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20220511 FILED AS OF DATE: 20220513 DATE AS OF CHANGE: 20220513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burkavage Brian CENTRAL INDEX KEY: 0001865633 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41008 FILM NUMBER: 22923448 MAIL ADDRESS: STREET 1: C/O PASSAGE BIO, INC. STREET 2: ONE COMMERCE SQUARE, 39TH FLOOR CITY: PHILADELPHIA STATE: PA ZIP: 19103 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IO Biotech, Inc. CENTRAL INDEX KEY: 0001865494 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 870909276 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: OLE MAALOES VEH 3 CITY: COPENHAGEN STATE: G7 ZIP: 2200 BUSINESS PHONE: 4570702980 MAIL ADDRESS: STREET 1: OLE MAALOES VEH 3 CITY: COPENHAGEN STATE: G7 ZIP: 2200 3 1 form3.xml X0206 3 2022-05-11 0 0001865494 IO Biotech, Inc. IOBT 0001865633 Burkavage Brian C/O IO BIOTECH, INC. OLE MAALOES VEH 3 COPENHAGEN G7 2200 DENMARK true Chief Accounting Officer Common Stock 1500 D Stock Option (Right to Buy) 8.52 2032-02-15 Common Stock 53000 D One-fourth of these options vest on 10/29/2022, and 1/48th of these options vest each month thereafter, subject to the reporting person's continued service through the applicable vesting date, and subject to 50% acceleration upon a change of control. Exhibit List: Exhibit 24 - Power of Attorney /s/ Brian Burkavage 2022-05-13 EX-24.1 2 efc22-281_ex241.htm
POWER OF ATTORNEY
 
Know all by these presents, that the undersigned hereby makes, constitutes and appoints Mai-Britt Zocca, with full power of substitution, the undersigned's true and lawful attorney-in-fact to:
 

 (1)
prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC;
 

 (2)
execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of IO Biotech, Inc., a Delaware corporation (the "Company"), Forms 3, 4, and 5, including amendments thereto, in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules and regulations thereunder;
 

 (3)
do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and
 

 (4)
take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such 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 such attorney-in-fact may approve in such attorney-in-fact's discretion.
 
The undersigned hereby grants to 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 attorney-in-fact, 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 Securities Exchange Act of 1934.

This Power of Attorney shall remain in full force and effect until 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, unless earlier (a) revoked by the undersigned in a signed writing delivered to the foregoing attorney-in-fact or (b) superseded by a new power of attorney regarding the purposes outlined herein at a later date.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 12th day of May, 2022.

 
 
 
 /s/ Brian Burkavage
 
 
 
 
 Signature
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Brian Burkavage
 
 
 
 
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