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*
Schlanger David J

(Last) (First) (Middle)
C/O PROGYNY, INC.
245 5TH AVENUE

(Street)
NEW YORK NY

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/24/2019
3. Issuer Name and Ticker or Trading Symbol
Progyny, Inc. [ PGNY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
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 880,010 D
Common Stock 220,002 I See Footnote(1)
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
Employee Stock Option (right to buy) (2) 08/03/2027 Common Stock 4,874,391 $0.91 D
Employee Stock Option (right to buy) (2) 08/16/2028 Common Stock 202,794 $1.5 D
Employee Stock Option (right to buy) (3) 05/23/2029 Common Stock 1,870,022 $3.96 D
Explanation of Responses:
1. The reportable securities are held directly by DS2019 LLC (the "LLC"), which is owned by David Schlanger 2019 Grantor Retained Annuity Trust (the "DS GRAT"). The Reporting Person is the managing member and sole owner of the LLC, and the Reporting Person's spouse is the trustee of the DS GRAT.
2. One-fourth (1/4th) of the shares subject to the Option vested on January 16, 2018, and one thirty-sixth (1/36th) of the remaining shares subject to the Option vested or shall vest each month thereafter, subject to the Reporting Person continuing to provide service through each such date.
3. One-fourth (1/4th) of the shares subject to the Option shall vest on May 23, 2020, and one thirty-sixth (1/36th) of the remaining shares subject to the Option shall vest each month thereafter, subject to the Reporting Person continuing to provide service through each such date.
Remarks:
Exhibit List - Exhibit 24 - Power of Attorney
/s/ Jennifer Bealer, Attorney-in-Fact 10/24/2019
** 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.