Initial Statement of Beneficial Ownership (3)
14 December 2021 - 09:56AM
Edgar (US Regulatory)
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
Koziel Margaret |
2. Date of Event Requiring Statement (MM/DD/YYYY)
12/1/2021
|
3. Issuer Name and Ticker or Trading Symbol
Axcella Health Inc. [AXLA]
|
(Last)
(First)
(Middle)
C/O AXCELLA HEALTH INC., 840 MEMORIAL DRIVE |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Chief Medical Officer / |
(Street)
CAMBRIDGE, MA 02139
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
Table I - Non-Derivative Securities Beneficially Owned
|
1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 30000 (1) | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (Right to Buy) | (2) | 6/27/2029 | Common Stock | 20800 | $9.31 | D | |
Stock Option (Right to Buy) | (3) | 1/2/2030 | Common Stock | 10250 | $4.12 | D | |
Stock Option (Right to Buy) | (4) | 11/10/2030 | Common Stock | 11000 | $5.04 | D | |
Stock Option (Right to Buy) | (5) | 2/9/2031 | Common Stock | 31050 | $6.59 | D | |
Stock Option (Right to Buy) | (6) | 6/25/2031 | Common Stock | 10000 | $4.11 | D | |
Explanation of Responses: |
(1) | Represents a grant of 30,000 Restricted Stock Units ("RSUs"), each representing a contingent right to receive one share of AXLA common stock. 25% of the shares underlying this grant vested on August 31, 2021, with the remainder vesting in twelve equal quarterly installments thereafter, subject to the Reporting Person's continued service on each such vesting date. |
(2) | 25% of the shares underlying this option vested and became exercisable on June 27, 2020, with the remainder vesting in twelve equal quarterly installments thereafter, subject to subject to Reporting Person's continued service on each such vesting date. |
(3) | 25% of the shares underlying this option vested and became exercisable on January 2, 2021, with the remainder vesting in twelve equal quarterly installments thereafter, subject to subject to Reporting Person's continued service on each such vesting date. |
(4) | 25% of the shares underlying this option vested and became exercisable on November 10, 2021, with the remainder vesting in twelve equal quarterly installments thereafter, subject to subject to Reporting Person's continued service on each such vesting date. |
(5) | 25% of the shares underlying this option shall vest and become exercisable on February 9, 2022, with the remainder vesting in twelve equal quarterly installments thereafter, subject to subject to Reporting Person's continued service on each such vesting date. |
(6) | 25% of the shares underlying this option shall vest and become exercisable on June 25, 2022, with the remainder vesting in twelve equal quarterly installments thereafter, subject to subject to Reporting Person's continued service on each such vesting date |
Remarks: Exhibit 24 - Power of Attorney |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Koziel Margaret C/O AXCELLA HEALTH INC. 840 MEMORIAL DRIVE CAMBRIDGE, MA 02139 |
|
| Chief Medical Officer |
|
Signatures
|
/s/ Paul Fehlner, Attorney-in-Fact | | 12/13/2021 |
**Signature of Reporting Person | Date |
Axcella Health (NASDAQ:AXLA)
Historical Stock Chart
From Feb 2024 to Mar 2024
Axcella Health (NASDAQ:AXLA)
Historical Stock Chart
From Mar 2023 to Mar 2024