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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Gjino Anjeza

(Last) (First) (Middle)
C/O CYCLERION THERAPEUTICS, INC.
245 FIRST STREET, 18TH FLOOR

(Street)
CAMBRIDGE MA 02142

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2021
3. Issuer Name and Ticker or Trading Symbol
Cyclerion Therapeutics, Inc. [ CYCN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial 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 15,224(1) D
Common Stock 18,199(2) D
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) (3) 12/01/2023 Common Stock 30 $14.4 D
Employee Stock Option (Right to Buy) (3) 12/02/2023 Common Stock 300 $12.68 D
Employee Stock Option (Right to Buy) (3) 12/16/2023 Common Stock 250 $11.95 D
Employee Stock Option (Right to Buy) (3) 03/03/2024 Common Stock 540 $15.54 D
Employee Stock Option (Right to Buy) (3) 11/03/2024 Common Stock 1,000 $14.87 D
Employee Stock Option (Right to Buy) (3) 03/16/2025 Common Stock 340 $17.2 D
Employee Stock Option (Right to Buy) (3) 10/01/2025 Common Stock 402 $11.52 D
Employee Stock Option (Right to Buy) (3) 03/01/2026 Common Stock 3,773 $11.28 D
Employee Stock Option (Right to Buy) (3) 01/29/2029 Common Stock 11,504 $14.21 D
Employee Stock Option (Right to Buy) (4) 09/06/2029 Common Stock 5,468 $10.1 D
Employee Stock Option (Right to Buy) (4) 11/04/2030 Common Stock 1,562 $2.48 D
Employee Stock Option (Right to Buy) (5) 01/29/2029 Common Stock 12,944 $14.21 D
Employee Stock Option (Right to Buy) (6) 09/06/2029 Common Stock 12,032 $10.1 D
Employee Stock Option (Right to Buy) (7) 11/22/2029 Common Stock 75,000 $2.01 D
Employee Stock Option (Right to Buy) (8) 11/04/2030 Common Stock 73,438 $2.48 D
Explanation of Responses:
1. Includes 7,204 shares acquired under the Issuer's 2019 Employee Stock Purchase Plan.
2. Consists of (i) 9,449 shares underlying unvested restricted stock units ("RSUs"), each representing the right to receive one share of Common Stock, received as a result of the equitable adjustment of outstanding RSUs held prior to the spin-off of the Issue from its predecessor, effective April1, 2019 (the "Separation"), that vest ratably on February 24, 2021, February 24, 2022 and February 23, 2023, and (ii) 8,750 shares issued under the Issuer's 2019 Equity Incentive Plan that vest ratably on August 12, 2021, August 11, 2022 and August 10, 2023.
3. These stock options are fully exercisable and were granted by the Issuer's predecessor and were equitably adjusted into stock options of the Issuer pursuant to the Separation.
4. These stock options were issued under the Issuer's 2019 Equity Incentive Plan and are fully exercisable.
5. These stock options vest and become exercisable ratably on the first day of each month until and including January 1, 2023.
6. These stock options vest and become exercisable ratably on the sixth day of each month until and including September 6, 2023.
7. These stock options vest and become exercisable upon the attainment of both performance-based and service-based hurdles, as follows: (i) 20% of the shares subject to the option, if the average closing price of the common stock reported by Nasdaq for any thirty (30) consecutive trading days equals or exceeds $10; plus an additional (ii) 40% of the shares, if the average closing price equals or exceeds $20; plus an additional (iii) 40% of the shares, if the average closing price equals or exceeds $30; in each case, subject to the continuous employment or service through the later of the date that the performance hurdles set forth above are attained (but no later than December 31, 2024) and December 31, 2021. To the extent unvested as of December 31, 2024, all of these performance-based options will be cancelled.
8. These stock options vest and become exercisable ratably on the fourth day of each month until and including November 4, 2024.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Anjeza Gjino 01/11/2021
** 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.