SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Mack David Henry

(Last) (First) (Middle)
C/O PMV PHARMACEUTICALS, INC.
8 CLARKE DRIVE, SUITE 3

(Street)
CRANBURY NJ 08512

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/24/2020
3. Issuer Name and Ticker or Trading Symbol
PMV Pharmaceuticals, Inc. [ PMVP ]
4. 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
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 227,915 I See footnote(1)
Common Stock 56,978 I See footnote(2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) (3) 05/11/2025 Common Stock 495,337 $0.53 D
Stock Option (right to buy) (4) 11/15/2026 Common Stock 240,644 $1.37 D
Stock Option (right to buy) (5) 05/15/2027 Common Stock 460,769 $2.95 D
Stock Option (right to buy) (6) 03/09/2030 Common Stock 219,748 $3.9 D
Explanation of Responses:
1. The shares are held of record by The Mack-Mulligan Revocable Trust, for which the Reporting Person serves as co-trustee.
2. The shares are held of record by the Mack/Mulligan 2020 Irrevocable Descendants' Trust, for which the Reporting Person serves as co-trustee.
3. One fourth of the shares subject to the option vested on May 12, 2016, and one forty-eighth of the remaining shares subject to the option vested each month thereafter.
4. One forty-eighth of the shares subject to the option vested on December 16, 2016, and one forty-eighth of the shares subject to the option vested each month thereafter.
5. One forty-eighth of the shares subject to the option vested on June 16, 2017, and one forty-eighth of the shares subject to the option shall vest each month thereafter.
6. One forty-eighth of the shares subject to the option vested on April 4, 2020, and one forty-eighth of the shares subject to the option shall vest each month thereafter.
Remarks:
/s/ David H. Mack 09/24/2020
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.