Statement of Changes in Beneficial Ownership (4)
06 March 2021 - 9:54AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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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1. Name and Address of Reporting Person
*
SCHIERMEIER ANDREW |
2. Issuer Name and Ticker or Trading Symbol
Intellia Therapeutics, Inc.
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NTLA
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) EVP, Chief Operating Officer |
(Last)
(First)
(Middle)
C/O INTELLIA THERAPEUTICS, INC., 40 ERIE STREET; SUITE 130 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/3/2021 |
(Street)
CAMBRIDGE, MA 02139
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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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 Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (right to buy) | $57.71 | 3/3/2021 | | A | | 78750 | | (1) | 3/2/2031 | Common Stock | 78750 | $0.00 | 78750 | D | |
Restricted Stock Unit | (2) | 3/3/2021 (2) | | A | | 13125 | | (2) | (2) | Common Stock | 13125 | $0.00 | 13125 | D | |
Explanation of Responses: |
(1) | This option was granted on March 3, 2021 with respect to 78,750 shares of Common Stock, with 25% vesting on January 1, 2022 and the remaining 75% vesting in 36 substantially equal monthly installments thereafter. |
(2) | On March 3, 2021, the reporting person was granted 13,125 Restricted Stock Units ("RSUs") pursuant to the Intellia Therapeutics, Inc. Amended and Restated 2015 Stock Option and Incentive Plan. Each RSU represents a contingent right to receive one share of the Company's common stock upon vesting, with 25% of the RSU vesting on January 1, 2022 and the remaining awards vesting as to 25% in substantially equal annual installments. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
SCHIERMEIER ANDREW C/O INTELLIA THERAPEUTICS, INC. 40 ERIE STREET; SUITE 130 CAMBRIDGE, MA 02139 |
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| EVP, Chief Operating Officer |
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Signatures
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/s/Jose Rivera, Attorney-In-Fact | | 3/5/2021 |
**Signature of Reporting Person | Date |
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