0001104659-19-034661.txt : 20190611
0001104659-19-034661.hdr.sgml : 20190611
20190611095801
ACCESSION NUMBER: 0001104659-19-034661
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190607
FILED AS OF DATE: 20190611
DATE AS OF CHANGE: 20190611
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: 5AM VENTURES III, L.P.
CENTRAL INDEX KEY: 0001456890
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 19890014
BUSINESS ADDRESS:
STREET 1: 2200 SAND HILL ROAD
STREET 2: SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-233-8600
MAIL ADDRESS:
STREET 1: 2200 SAND HILL ROAD
STREET 2: SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: 5AM Partners III, LLC
CENTRAL INDEX KEY: 0001555953
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 19890015
BUSINESS ADDRESS:
STREET 1: 2200 SAND HILL ROAD STE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650.233.8600
MAIL ADDRESS:
STREET 1: 2200 SAND HILL ROAD STE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: 5AM Co-Investors III, L.P.
CENTRAL INDEX KEY: 0001478660
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 19890016
BUSINESS ADDRESS:
STREET 1: 2200 SAND HILL ROAD, SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-233-8600
MAIL ADDRESS:
STREET 1: 2200 SAND HILL ROAD, SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DIEKMAN JOHN D
CENTRAL INDEX KEY: 0001240357
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 19890017
MAIL ADDRESS:
STREET 1: C/O 5 AM VENTURES
STREET 2: 3000 SAND HILL RD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ROCKLAGE SCOTT M
CENTRAL INDEX KEY: 0001219014
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 19890018
MAIL ADDRESS:
STREET 1: 179 SANDY POND ROAD
CITY: LINCOLN
STATE: MA
ZIP: 01773
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Schwab Andrew J.
CENTRAL INDEX KEY: 0001598549
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 19890019
MAIL ADDRESS:
STREET 1: C/O 5AM VENTURES, 2200 SAND HILL ROAD
STREET 2: SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ARVINAS, INC.
CENTRAL INDEX KEY: 0001655759
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 472566120
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 395 WINCHESTER AVE
STREET 2: 5 SCIENCE PARK
CITY: NEW HAVEN
STATE: CT
ZIP: 06511
BUSINESS PHONE: 203-535-1456
MAIL ADDRESS:
STREET 1: 395 WINCHESTER AVE
STREET 2: 5 SCIENCE PARK
CITY: NEW HAVEN
STATE: CT
ZIP: 06511
FORMER COMPANY:
FORMER CONFORMED NAME: ARVINAS INC.
DATE OF NAME CHANGE: 20181001
FORMER COMPANY:
FORMER CONFORMED NAME: ARVINAS HOLDING COMPANY, LLC
DATE OF NAME CHANGE: 20151015
4
1
a4.xml
4
X0306
4
2019-06-07
0
0001655759
ARVINAS, INC.
ARVN
0001456890
5AM VENTURES III, L.P.
501 SECOND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001555953
5AM Partners III, LLC
501 SECOND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001478660
5AM Co-Investors III, L.P.
501 SECOND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001240357
DIEKMAN JOHN D
501 SECOND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001219014
ROCKLAGE SCOTT M
501 SECOND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001598549
Schwab Andrew J.
501 SECOND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
Common Stock
2019-06-07
4
S
0
185226
19.65
D
4326910
I
See footnotes
Common Stock
2019-06-07
4
S
0
4774
19.65
D
111513
I
See footnotes
These Securities are held of record by 5AM Ventures III, L.P. ("Ventures III").
These Securities are held of record by 5AM Co-Investors III, L.P. ("Co-Investors III").
5AM Partners III, LLC ("Partners III") is the sole general partner of Ventures III and Co-Investors III. Dr. John D. Diekman, Andrew J. Schwab and Dr. Scott M. Rocklage are the managing members of Partners III, and may be deemed to have shared voting and investment power over the shares beneficially owned by Ventures III and Co-Investors III. Each of Partners III, Dr. Diekman, Mr. Schwab and Dr. Rocklage disclaim beneficial ownership of such shares except to the extent of its or his pecuniary interest therein.
5AM PARTNERS III, LLC By: /s/ Andrew J. Schwab Name: Andrew J. Schwab Title: Managing Member
2019-06-11
5AM VENTURES III, L.P. By: 5AM Partners III, LLC Its: General Partner By: /s/ Andrew J. Schwab Name: Andrew J. Schwab Title: Managing Member
2019-06-11
5AM CO-INVESTORS III, L.P. By: 5AM Partners III, LLC Its: General Partner By: /s/ Andrew J. Schwab Name: Andrew J. Schwab Title: Managing Member
2019-06-11
By: /s/ John D. Diekman
2019-06-11
By: /s/ Scott M. Rocklage
2019-06-11
By: /s/ Andrew Schwab
2019-06-11