SEC FORM
3
SEC Form 3
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
888 BOYLSTON STREET |
SUITE 1111 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/26/2019
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3. Issuer Name and Ticker or Trading Symbol
Morphic Holding, Inc.
[ MORF ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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No securities beneficially held |
0 |
D |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series A Preferred Stock |
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Common Stock |
857,470 |
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D
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Series B Preferred Stock |
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Common Stock |
1,978,779 |
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D
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1. Name and Address of Reporting Person*
888 BOYLSTON STREET |
SUITE 1111 |
(Street)
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1. Name and Address of Reporting Person*
888 BOYLSTON STREET |
SUITE 1111 |
(Street)
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1. Name and Address of Reporting Person*
888 BOYLSTON STREET |
SUITE 1111 |
(Street)
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1. Name and Address of Reporting Person*
888 BOYLSTON STREET |
SUITE 1111 |
(Street)
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1. Name and Address of Reporting Person*
888 BOYLSTON STREET |
SUITE 1111 |
(Street)
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1. Name and Address of Reporting Person*
888 BOYLSTON STREET |
SUITE 1111 |
(Street)
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1. Name and Address of Reporting Person*
888 BOYLSTON STREET |
SUITE 1111 |
(Street)
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Explanation of Responses: |
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By Omega Fund V, L.P., by Omega Fund GP, L.P., its general partner, by Omega Fund V GP Manager, Ltd., its general partner, /s/ Anne-Mari Paster, Director |
06/26/2019 |
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By Omega Fund GP, L.P., its general partner, by Omega Fund V GP Manager, Ltd., its general partner, /s/ Anne-Mari Paster, Director |
06/26/2019 |
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By Omega Fund V GP Manager, Ltd., its general partner, /s/ Anne-Mari Paster, Director |
06/26/2019 |
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/s/ Anne-Mari Paster, attorney-in-fact for Richard J. Lim |
06/26/2019 |
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/s/ Claudio Nessi |
06/26/2019 |
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/s/ Anne-Mari Paster |
06/26/2019 |
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/s/ Anne-Mari Paster, attorney-in-fact for Otello Stampacchia |
06/26/2019 |
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** Signature of Reporting Person |
Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* If the form is filed by more than one reporting person,
see
Instruction
5
(b)(v). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
POWER OF ATTORNEY
Know all by these presents, that each of the undersigned hereby
constitutes and appoints each other undersigned, such person's true and lawful
attorney-in-fact, to:
(I) execute for and on behalf of each of such person Forms 3, 4, and 5
and Schedules 13D or 13G, as appropriate, and any required
amendments thereto (collectively, the "Repo11s"), with respect to
their current or future beneficial ownership of securities of any
public company, in accordance with Section 13(d) and/or Section
16(a) of the Securities Exchange Act of 1934, as amended, and the
respective rules (including Rule l3d-l) promulgated thereunder;
(2) do and perform any and all acts for and on behalf of such person
which may be necessary or desirable to complete and execute any
such Report and timely file such form with the United States
Securities and Exchange Commission and any stock exchange or
similar authority; and
(3) take any other action of any type whatsoever in connection with
the foregoing which, in the opinion of an attorney-in-fact, may be
of benefit to, in the best interest of, or legally required by,
such person, it being understood that the documents executed by an
attorney-in-fact on behalf of such person 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.
Each of the undersigned hereby grants to each 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 each
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. Each of the undersigned hereby ratifies and
confirms each Report that has been signed by any other undersigned prior to the
date hereof. Each of the undersigned acknowledges that each foregoing
attorney-in-fact, in serving in such capacity at the request of the
undersigned, is not assuming any of the undersigneds' responsibilities to
comply with Section 13(d) or Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned are no longer required to file Reports with respect to the
undersigneds' current or future holdings of and transactions in securities
issued by any public company, unless earlier revoked by the undersigned in a
signed writing delivered to each foregoing attorney-in-fact.
[The remainder of this page is intentionally left blank.]
IN WITNESS WHEREOF, the undersigned have caused this Power of Attorney to
be executed as of dates set forth opposite their names.
Dated: 7/18/18 /s/Otello Stampacchia
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Otello Stampacchia
Dated: 7/18/18 /s/Richard Lim
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Dated: 7/18/18 /s/Anne-Mari Paster
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Anne-Mari Paster