Initial Statement of Beneficial Ownership (3)
February 09 2021 - 4:37PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
*
Minai-Azary Jennifer Lynn |
2. Date of Event Requiring Statement (MM/DD/YYYY)
2/1/2021
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3. Issuer Name and Ticker or Trading Symbol
Millendo Therapeutics, Inc. [MLND]
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(Last)
(First)
(Middle)
C/O MILLENDO THERAPEUTICS, INC., 110 MILLER AVENUE, SUITE 100 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Chief Financial Officer / |
(Street)
ANN ARBOR, MI 48104
(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
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Table I - Non-Derivative Securities Beneficially Owned
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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) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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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) | (1) | 8/21/2023 | Common Stock | 2969.0 | $1.08 | D | |
Stock Option (right to buy) | (1) | 5/27/2024 | Common Stock | 989.0 | $2.69 | D | |
Stock Option (right to buy) | (1) | 1/27/2026 | Common Stock | 12382.0 | $4.44 | D | |
Stock Option (right to buy) | (1) | 11/2/2026 | Common Stock | 12840.0 | $8.47 | D | |
Stock Option (right to buy) | (2) | 8/23/2028 | Common Stock | 11160.0 | $16.4 | D | |
Stock Option (right to buy) | (3) | 1/31/2029 | Common Stock | 18000.0 | $10.48 | D | |
Stock Option (right to buy) | (4) | 6/20/2029 | Common Stock | 7000.0 | $11.59 | D | |
Stock Option (right to buy) | (5) | 1/30/2030 | Common Stock | 20000.0 | $7.94 | D | |
Stock Option (right to buy) | (6) | 5/24/2030 | Common Stock | 20000.0 | $2.0 | D | |
Explanation of Responses: |
(1) | Shares subject to this option are fully vested. |
(2) | Twenty-five percent (25%) of the shares subject to this option vested on August 20, 2019, and one thirty-sixth (1/36th) of the remaining shares subject to this option shall vest each month thereafter, subject to the Reporting Person continuing to provide service through each such date. |
(3) | Twenty-five percent (25%) of the shares subject to this option vested on January 31, 2020, and one thirty-sixth (1/36th) of the remaining shares subject to this option shall vest each month thereafter, subject to the Reporting Person continuing to provide service through each such date. |
(4) | Twenty-five percent (25%) of the shares subject to this option vested on June 20, 2020, and one thirty-sixth (1/36th) of the remaining shares subject to this option shall vest each month thereafter, subject to the Reporting Person continuing to provide service through each such date. |
(5) | Twenty-five percent (25%) of the shares subject to this option vested on January 31, 2021, and one thirty-sixth (1/36th) of the remaining shares subject to this option shall vest each month thereafter, subject to the Reporting Person continuing to provide service through each such date. |
(6) | Fifty percent (50%) of the shares subject to this option vested on December 31, 2020, and one twelfth (1/12th) of the remaining shares subject to this option shall vest in equal monthly installments thereafter, subject to the Reporting Person continuing to provide service to the Issuer through each such date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Minai-Azary Jennifer Lynn C/O MILLENDO THERAPEUTICS, INC. 110 MILLER AVENUE, SUITE 100 ANN ARBOR, MI 48104 |
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| Chief Financial Officer |
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Signatures
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/s/ Jennifer L. Minai-Azary | | 2/9/2021 |
**Signature of Reporting Person | Date |
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