SEC Form 4 · accession 0001104659-16-130144

SELECTA BIOSCIENCES INC · SELB

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Amir Nashat

Director · 10% Owner

Period of report

Jun 27, 2016

Accepted (ET)

Jun 29, 2016 · 4:45 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001453687

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	Jun 27, 2016	C	32,207	$0.00	A	32,972	I	See Footnote
Common Stock^F3,F4	Jun 27, 2016	C	11,318	$0.00	A	11,586	I	See Footnote
Common Stock^F5,F6	Jun 27, 2016	C	16,524	$0.00	A	16,916	I	See Footnote
Common Stock^F7,F8	Jun 27, 2016	C	1,652,646	$0.00	A	1,691,963	I	See Footnote
Common Stock^F1,F2	Jun 27, 2016	P	2,821	$14.00	A	35,793	I	See Footnote
Common Stock^F3,F4	Jun 27, 2016	P	991	$14.00	A	12,577	I	See Footnote
Common Stock^F5,F6	Jun 27, 2016	P	1,448	$14.00	A	18,364	I	See Footnote
Common Stock^F7,F8	Jun 27, 2016	P	144,740	$14.00	A	1,836,703	I	See Footnote

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Series A Convertible Preferred Stock^F1,F2,F9	—	Jun 27, 2016	C	6,494	D	—	—	Common Stock	6,494	I
Series A Convertible Preferred Stock^F3,F4,F9	—	Jun 27, 2016	C	2,282	D	—	—	Common Stock	2,282	I
Series A Convertible Preferred Stock^F5,F6,F9	—	Jun 27, 2016	C	3,332	D	—	—	Common Stock	3,332	I
Series A Convertible Preferred Stock^F7,F8,F9	—	Jun 27, 2016	C	333,207	D	—	—	Common Stock	333,207	I
Series B Convertible Preferred Stock^F1,F2,F9	—	Jun 27, 2016	C	11,875	D	—	—	Common Stock	11,875	I
Series B Convertible Preferred Stock^F3,F4,F9	—	Jun 27, 2016	C	4,174	D	—	—	Common Stock	4,174	I
Series B Convertible Preferred Stock^F5,F6,F9	—	Jun 27, 2016	C	6,093	D	—	—	Common Stock	6,093	I
Series B Convertible Preferred Stock^F7,F8,F9	—	Jun 27, 2016	C	609,316	D	—	—	Common Stock	609,316	I
Series C Convertible Preferred Stock^F1,F2,F9	—	Jun 27, 2016	C	4,420	D	—	—	Common Stock	4,420	I
Series C Convertible Preferred Stock^F3,F4,F9	—	Jun 27, 2016	C	1,553	D	—	—	Common Stock	1,553	I
Series C Convertible Preferred Stock^F5,F6,F9	—	Jun 27, 2016	C	2,267	D	—	—	Common Stock	2,267	I
Series C Convertible Preferred Stock^F7,F8,F9	—	Jun 27, 2016	C	226,801	D	—	—	Common Stock	226,801	I
Series D Convertible Preferred Stock^F1,F2,F9	—	Jun 27, 2016	C	4,647	D	—	—	Common Stock	4,647	I
Series D Convertible Preferred Stock^F3,F4,F9	—	Jun 27, 2016	C	1,632	D	—	—	Common Stock	1,632	I
Series D Convertible Preferred Stock^F5,F6,F9	—	Jun 27, 2016	C	2,384	D	—	—	Common Stock	2,384	I
Series D Convertible Preferred Stock^F7,F8,F9	—	Jun 27, 2016	C	238,470	D	—	—	Common Stock	238,470	I
Series E Convertible Preferred Stock^F1,F2,F10	—	Jun 27, 2016	C	3,078	D	—	—	Common Stock	4,771	I
Series E Convertible Preferred Stock^F3,F4,F10	—	Jun 27, 2016	C	1,082	D	—	—	Common Stock	1,677	I
Series E Convertible Preferred Stock^F5,F6,F10	—	Jun 27, 2016	C	1,579	D	—	—	Common Stock	2,448	I
Series E Convertible Preferred Stock^F7,F8,F10	—	Jun 27, 2016	C	157,957	D	—	—	Common Stock	244,852	I

Explanation of responses

F1The reportable securities are owned directly by Polaris Venture Partners Entrepreneurs' Fund V, L.P. ("PVPE V"). Polaris Venture Management Co. V, L.L.C. ("PVM V") is the general partner of PVPE V. PVM V disclaims beneficial ownership of these securities and this report shall not be deemed an admission that PVM V is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein.
F10The Series E Convertible Preferred Stock is convertible at any time, at the holder's election and has no expiration date. The Series E Convertible Preferred Stock automatically converted into common stock on an approximately 1-for-1.550115 basis upon the closing of the Issuer's initial public offering.
F2Each of Jonathan A. Flint ("Flint") and Terrance G. McGuire ("McGuire") are the managing members of PVM V. The Reporting Person, who is a member of the Issuer's Board of Directors, is a member of PVM V. Each of Flint, McGuire and the Reporting Person, in their respective capacities with regard to PVM V, may be deemed to have shared voting and dispositive power of the shares held by PVPE V. Each of Flint, McGuire and the Reporting Person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interest therein.
F3The reportable securities are owned directly by Polaris Venture Partners Founders' Fund V, L.P. ("PVPFF V"). PVM V is the general partner of PVPFF V. PVM V disclaims beneficial ownership of these securities and this report shall not be deemed an admission that PVM V is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein.
F4Each of Flint and McGuire are the managing members of PVM V. The Reporting Person, who is a member of the Issuer's Board of Directors, is a member of PVM V. Each of Flint, McGuire and the Reporting Person, in their respective capacities with regard to PVM V, may be deemed to have shared voting and dispositive power of the shares held by PVPFF V. Each of Flint, McGuire and the Reporting Person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interest therein.
F5The reportable securities are owned directly by Polaris Venture Partners Special Founders' Fund V, L.P. ("PVPSFF V"). PVM V is the general partner of PVPSFF V. PVM V disclaims beneficial ownership of these securities and this report shall not be deemed an admission that PVM V is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein.
F6Each of Flint and McGuire are the managing members of PVM V. The Reporting Person, who is a member of the Issuer's Board of Directors, is a member of PVM V. Each of Flint, McGuire and the Reporting Person, in their respective capacities with regard to PVM V, may be deemed to have shared voting and dispositive power of the shares held by PVPSFF V. Each of Flint, McGuire and the Reporting Person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interest therein.
F7The reportable securities are owned directly by Polaris Venture Partners V, L.P. ("PVP V"). PVM V is the general partner of PVP V. PVM V disclaims beneficial ownership of these securities and this report shall not be deemed an admission that PVM V is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein.
F8Each of Flint and McGuire are the managing members of PVM V. The Reporting Person, who is a member of the Issuer's Board of Directors, is a member of PVM V. Each of Flint, McGuire and the Reporting Person, in their respective capacities with regard to PVM V, may be deemed to have shared voting and dispositive power of the shares held by PVP V. Each of Flint, McGuire and the Reporting Person disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their pecuniary interest therein.
F9The preferred stock is convertible at any time, at the holder's election and has no expiration date. The preferred stock automatically converted into common stock on a 1-for-1 basis upon the closing of the Issuer's initial public offering.