SEC Form 4 · accession 0000899243-18-030866
Moderna, Inc. · MRNA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Paul Sagan
Director
Period of report
Dec 11, 2018
Accepted (ET)
Dec 13, 2018 · 4:25 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001682852
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Dec 11, 2018 | C | 367,776 | — | A | 367,776 | I | By: The Paul Sagan Revocable Trust |
| Common StockF2 | holding | — | — | — | 17,201 | I | By: Erwin Park LLC | |
| Common StockF2 | holding | — | — | — | 76,452 | I | By: The Chatham Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series B Preferred StockF1,F2 | — | Dec 11, 2018 | C | 367,776 | D | — | — | Common Stock | 367,776 | 0 | I |
Explanation of responses
- F1The Series B Preferred Stock (the "Preferred Stock") converted into Common Stock based on an applicable conversion ratio of 0.45457 upon the closing of the Issuer's initial public offering on December 11, 2018. The Preferred Stock had no expiration date.
- F2Erwin Park LLC is an estate planning vehicle for the Reporting Person's family. The Chatham Trust is an irrevocable family trust for which the Reporting Person serves as a trustee. The Paul Sagan Revocable Trust is a revocable trust for which the Reporting Person serves as a trustee. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.