Statement of Changes in Beneficial Ownership (4)
June 21 2021 - 4:19PM
Edgar (US Regulatory)
FORM 4
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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
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Brown Willie L. Jr. |
2. Issuer Name and Ticker or Trading Symbol
Global Blood Therapeutics, Inc.
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GBT
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O GLOBAL BLOOD THERAPEUTICS, INC., 181 OYSTER POINT BLVD. |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/17/2021 |
(Street)
SOUTH SAN FRANCISCO, CA 94080
(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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Common Stock | 6/17/2021 | | M | | 3037 | A | (1) | 39265 | D | |
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 |
Restricted Stock Units | (1) | 6/17/2021 | | M | | | 3037 | 6/17/2021 (2) | (2) | Common Stock | 3037 | $0.00 | 0 | D | |
Stock Option (Right to Buy) | $37.09 | 6/17/2021 | | A | | 5600 | | (3) | 6/16/2031 | Common Stock | 5600 | $0.00 | 5600 | D | |
Restricted Stock Units | (1) | 6/17/2021 | | A | | 3600 | | (4) | (4) | Common Stock | 3600 | $0.00 | 3600 | D | |
Explanation of Responses: |
(1) | Each Restricted Stock Unit ("RSU") represents a contingent right to receive one share of the Issuer's Common Stock. |
(2) | The RSUs vested in a single installment on June 17, 2021. |
(3) | The shares subject to this option shall vest and become exercisable in equal monthly installments over a period of 12 months following June 17, 2021 for 11 months and the remaining 1/12th on the earlier of (i) June 17, 2022 or (ii) the Issuer's next annual meeting of stockholders, in each case subject to the Reporting Person's continued service on the Issuer's Board of Directors. This option is subject to full acceleration of vesting with respect to all then-unvested shares upon the consummation of a Sale Event (as defined in the Issuer's 2015 Stock Option and Incentive Plan, as amended). |
(4) | The shares of Common Stock underlying the RSUs vest in a single installment on the earlier of (i) June 17, 2022 or (ii) the Issuer's next annual meeting of stockholders, in each case subject to the Reporting Person's continued service on the Issuer's Board of Directors. The shares of Common Stock underlying the RSUs are subject to full acceleration of vesting with respect to all then-unvested shares upon the consummation of a Sale Event (as defined in the Issuer's 2015 Stock Option and Incentive Plan, as amended). |
Remarks: EXHIBIT 24: Power of Attorney |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Brown Willie L. Jr. C/O GLOBAL BLOOD THERAPEUTICS, INC. 181 OYSTER POINT BLVD. SOUTH SAN FRANCISCO, CA 94080 | X |
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Signatures
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/s/ Miguel Carrillo, Attorney-in-Fact | | 6/21/2021 |
**Signature of Reporting Person | Date |
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