Statement of Changes in Beneficial Ownership (4)
April 04 2022 - 04:34PM
Edgar (US Regulatory)
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FORM 4
[ ] Check this box if no longer subject to Section
16. Form 4 or Form 5 obligations may continue. See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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OMB
APPROVAL
OMB Number: 3235-0287
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 * Evans Elizabeth
E. |
2. Issuer Name and Ticker or Trading
Symbol VACCINEX, INC. [ VCNX ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Operating Officer |
|
(Last)
(First)
(Middle)
C/O VACCINEX, INC., 1895 MOUNT HOPE AVENUE |
3. Date of Earliest Transaction (MM/DD/YYYY)
4/1/2022
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|
(Street)
ROCHESTER, NY 14620
(City)
(State)
(Zip)
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4. 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 Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
|
Code |
V |
Amount |
(A) or (D) |
Price |
|
Common Stock |
|
|
|
|
|
|
|
9600 |
D |
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
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) |
$7.1 |
|
|
|
|
|
|
(1) |
12/22/2025 |
Common Stock |
9610 |
|
9610 |
D |
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|
Stock Option (Right to Buy) |
$7.1 |
|
|
|
|
|
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(1) |
12/23/2025 |
Common Stock |
8605 |
|
8605 |
D |
|
|
Stock Option (Right to Buy) |
$3.9 |
|
|
|
|
|
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(2) |
3/14/2029 |
Common Stock |
12400 |
|
12400 |
D |
|
|
Stock Option (Right to Buy) |
$3.82 |
|
|
|
|
|
|
(3) |
4/4/2030 |
Common Stock |
10000 |
|
10000 |
D |
|
|
Stock Option (Right to Buy) |
$2.93 |
|
|
|
|
|
|
(4) |
4/3/2031 |
Common Stock |
8000 |
|
8000 |
D |
|
|
Stock Option (Right to Buy) |
$1.29 |
4/1/2022 |
|
A |
|
20000 |
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(5) |
4/1/2032 |
Common Stock |
20000 |
$0 |
20000 |
D |
|
| Explanation of
Responses: |
| (1) |
This option is fully
exercisable as of the date of this report. |
| (2) |
This option has vested with
respect to 9,300 shares and the remainder vests on March 15,
2023. |
| (3) |
This option has vested with
respect to 5,000 shares and the remainder vests in two equal annual
installments beginning on April 3, 2023. |
| (4) |
This option vests one-fourth
on each of the first four anniversaries of the April 2, 2021 grant
date. |
| (5) |
This option was granted
under the Company's 2018 Omnibus Incentive Plan in a transaction
exempt under Rule 16b-3 and, except as otherwise provided in the
award notice, vests one-fourth on each of the first four
anniversaries of the April 1, 2022 grant date. |
Reporting
Owners
|
|
Reporting Owner Name / Address |
Relationships
|
|
Director |
10% Owner |
Officer |
Other |
Evans Elizabeth E.
C/O VACCINEX, INC.
1895 MOUNT HOPE AVENUE
ROCHESTER, NY 14620 |
|
|
Chief Operating Officer |
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Signatures
|
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/s/ Scott E. Royer, Attorney-in-Fact for
Elizabeth E. Evans |
|
4/4/2022 |
| **Signature of Reporting
Person |
Date |
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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 4(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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