Amended Statement of Changes in Beneficial Ownership (4/a)
September 24 2021 - 7:01PM
Edgar (US Regulatory)
FORM 4
[ ]
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
*
LOVE TED W |
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
__X__ Officer (give title below) _____ Other (specify below)
President and CEO |
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(Last)
(First)
(Middle)
C/O GLOBAL BLOOD THERAPEUTICS, INC., 181 OYSTER POINT BOULEVARD |
3. Date of Earliest Transaction
(MM/DD/YYYY)
8/1/2021 |
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(Street)
SOUTH SAN FRANCISCO, CA 94080
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
8/3/2021 |
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 | 8/1/2021 | | M | | 29955 | A | (1) | 804266 | D | |
| Common Stock | 8/1/2021 | | F | | 14853 (2) | D | $27.33 | 789413 | D | |
| Common Stock | | | | | | | | 102000 | I | By Trust 1 |
| Common Stock | | | | | | | | 102000 | I | By Trust 2 |
| Common Stock | | | | | | | | 102000 | I | By Trust 3 |
| Common Stock | | | | | | | | 2500 | I | By Daughter |
| Common Stock | | | | | | | | 2500 | I | By Daughter |
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) | 8/1/2021 | | M | | | 9750 | (3) | (3) | Common Stock | 9750 | $0.00 | 9750 | D | |
| Restricted Stock Units | (1) | 8/1/2021 | | M | | | 11250 | (4) | (4) | Common Stock | 11250 | $0.00 | 33750 | D | |
| Restricted Stock Units | (1) | 8/1/2021 | | M | | | 8955 | (5) | (5) | Common Stock | 8955 | $0.00 | 44775 | D | |
| Explanation of Responses: |
| (1) | Each Restricted Stock Unit ("RSU") represents the right to receive one share of the Issuer's Common Stock. |
| (2) | Represents number of shares of Issuer's Common Stock withheld to satisfy the Reporting Person's tax obligations in connection with the vesting of 29,955 shares of Common Stock underlying the Reporting Person's RSUs. |
| (3) | The shares of Common Stock underlying the RSUs vested in 8 equal semi-annual installments over 4 years from February 1, 2017. |
| (4) | The shares of Common Stock underlying the RSUs vest in 8 equal semi-annual installments over 4 years from February 1, 2018, so long as the Reporting Person continues as an employee or other service provider of the Issuer through each vesting date. The RSUs are subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
| (5) | The shares of Common Stock underlying the RSUs vest in 8 equal semi-annual installments over 4 years from February 1, 2019, so long as the Reporting Person continues as an employee or other service provider of the Issuer through each vesting date. The RSUs are subject to accelerated vesting upon termination without cause or resignation for good reason after a change of control of the Issuer. |
Remarks:
This amended Form 4 is being filed solely to attach a Power of Attorney granted by the Reporting Person which was not previously attached. All other information in the original Form 4 remains the same. The original Form 4 was timely filed on August 3, 2021.
Exhibit 24 - Power of Attorney |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
LOVE TED W
C/O GLOBAL BLOOD THERAPEUTICS, INC.
181 OYSTER POINT BOULEVARD
SOUTH SAN FRANCISCO, CA 94080 | X |
| President and CEO |
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Signatures
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| /s/ Miguel Carrillo, as Attorney-in-Fact | | 9/24/2021 |
| **Signature of Reporting Person | Date |
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