Initial Statement of Beneficial Ownership (3)
March 16 2023 - 05:04PM
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 |
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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 * Jordan Julie |
2. Date of Event Requiring Statement
(MM/DD/YYYY)
3/7/2023
|
3. Issuer Name and Ticker or Trading
Symbol Homology Medicines, Inc. [FIXX] |
(Last)
(First)
(Middle)
C/O HOMOLOGY MEDICINES, INC., ONE PATRIOTS PARK |
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)
BEDFORD, MA 01730
(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 |
2519 |
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 |
Employee Stock Option (Right to Buy) |
(1) |
6/2/2031 |
Common Stock |
65000 |
$6.53 |
D |
|
Employee Stock Option (Right to Buy) |
(2) |
2/24/2032 |
Common Stock |
56000 |
$2.71 |
D |
|
Employee Stock Option (Right to Buy) |
(3) |
3/2/2032 |
Common Stock |
9000 |
$3.59 |
D |
|
Employee Stock Option (Right to Buy) |
(4) |
2/23/2033 |
Common Stock |
143000 |
$1.60 |
D |
|
Restricted Stock Units |
(5) |
(6) |
Common Stock |
350 |
(6) |
D |
|
Restricted Stock Units |
(7) |
(6) |
Common Stock |
5360 |
(6) |
D |
|
Restricted Stock Units |
(8) |
(6) |
Common Stock |
1340 |
(6) |
D |
|
Restricted Stock Units |
(9) |
(6) |
Common Stock |
24000 |
(6) |
D |
|
Explanation of
Responses: |
(1) |
The option vests or has
vested as to 25% of the underlying shares on May 3, 2022 and in 36
substantially equal monthly installments upon the Reporting
Person's completion of each full month of service thereafter so
that such option will become fully vested on May 3,
2025. |
(2) |
The option vests in 48
substantially equal monthly installments upon the Reporting
Person's completion of each full month of service following January
1, 2022 so that such option will become fully vested on January 1,
2026. |
(3) |
The option vests in 48
substantially equal monthly installments upon the Reporting
Person's completion of each full month of service following January
1, 2022 so that such option will become fully vested on January 1,
2026. |
(4) |
The option vests in 48
substantially equal monthly installments upon the Reporting
Person's completion of each full month of service following January
1, 2023 so that such option will become fully vested on January 1,
2027. |
(5) |
The restricted stock units
will vest and settle in full on August 2, 2023. |
(6) |
Each restricted stock unit
represents a contingent right to receive one share of Issuer common
stock. The restricted stock units have no expiration
date. |
(7) |
The restricted stock units
will vest and settle as to one half of the restricted stock units
on each of January 1, 2024 and January 1, 2025. |
(8) |
The restricted stock units
will vest and settle as to one half of the restricted stock units
on each of January 1, 2024 and January 1, 2025. |
(9) |
The restricted stock units
will vest and settle as to one third of the restricted stock units
on each of the first three anniversaries of January 1, 2023 so that
such RSUs will become fully vested on January 1, 2026. |
Remarks:
Exhibit 24 - Power of Attorney. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Jordan Julie
C/O HOMOLOGY MEDICINES, INC.
ONE PATRIOTS PARK
BEDFORD, MA 01730 |
|
|
Chief Medical Officer |
|
Signatures
|
/s/ Paul Alloway, Attorney-in-Fact for Julie
Jordan |
|
3/16/2023 |
**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 control number. |
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