0001209191-19-043059.txt : 20190724
0001209191-19-043059.hdr.sgml : 20190724
20190724165514
ACCESSION NUMBER: 0001209191-19-043059
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190722
FILED AS OF DATE: 20190724
DATE AS OF CHANGE: 20190724
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MAKOWER JOSHUA
CENTRAL INDEX KEY: 0001235952
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38981
FILM NUMBER: 19971589
MAIL ADDRESS:
STREET 1: 1212 TERRA BELLA AVENUE
CITY: MOUNTAIN VIEW
STATE: CA
ZIP: 94043
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Mirum Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001759425
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 831281555
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 950 TOWER LANE, SUITE 1050
CITY: FOSTER CITY
STATE: CA
ZIP: 94404
BUSINESS PHONE: 650-667-4085
MAIL ADDRESS:
STREET 1: 950 TOWER LANE, SUITE 1050
CITY: FOSTER CITY
STATE: CA
ZIP: 94404
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-07-22
0
0001759425
Mirum Pharmaceuticals, Inc.
MIRM
0001235952
MAKOWER JOSHUA
1954 GREENSPRING DRIVE, SUITE 600
TIMONIUM
MD
21093
0
0
1
0
Common Stock
2019-07-22
4
C
0
3736243
A
3736243
I
See Note 2
Common Stock
2019-07-22
4
P
0
450000
15.00
A
4186243
I
See Note 2
Series A Preferred Stock
2019-07-22
4
C
0
29889945
0.00
D
Common Stock
3736243
0
I
See Note 2
Automatic conversion, in connection with the Issuer's initial public offering, of each share of the Issuer's Series A preferred stock into 0.125
shares of the Issuer's common stock. The shares have no expiration date.
The Reporting Person is a manager of NEA 16 GP, LLC, ("NEA 16 GP") which is the sole general partner of NEA Partners 16, L.P. ("NEA
Partners 16"). NEA Partners 16 is the sole general partner of New Enterprise Associates 16, L.P. ("NEA 16"), which is the direct beneficial owner
of the shares. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as
amended, or otherwise of such portion of the shares held by NEA 16 in which the Reporting Person has no pecuniary interest.
The shares were purchased in the Issuer's initial public offering.
/s/ Sasha Keough, attorney-in-fact
2019-07-24