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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/24/2019 |
3. Issuer Name and Ticker or Trading Symbol
Ra Pharmaceuticals, Inc. [ RARX ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 | 14,285 | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Option to Purchase Common Stock | (1) | 06/14/2022 | Common Stock | 2,857 | $0.84 | D | |
Option to Purchase Common Stock | (1) | 12/11/2024 | Common Stock | 14,285 | $2.87 | D | |
Option to Purchase Common Stock | (2) | 12/10/2025 | Common Stock | 30,000 | $2.87 | D | |
Option to Purchase Common Stock | (3) | 08/16/2026 | Common Stock | 31,428 | $5.6 | D | |
Option to Purchase Common Stock | (4) | 02/01/2027 | Common Stock | 60,000 | $16.64 | D | |
Option to Purchase Common Stock | (5) | 02/01/2028 | Common Stock | 26,250 | $7.33 | D | |
Option to Purchase Common Stock | (6) | 02/01/2029 | Common Stock | 107,000 | $21 | D | |
Restricted Stock Units | (7) | (8) | Common Stock | 8,750 | $0(9) | D |
Explanation of Responses: |
1. The shares underlying these options are fully vested and exercisable. |
2. These stock options vest in 48 equal monthly installments on each monthly anniversary following December 10, 2015, the grant date. |
3. These stock options vest in 48 equal monthly installments on each monthly anniversary following August 16, 2016, the grant date. |
4. These stock options vest in 48 equal monthly installments on each monthly anniversary following February 1, 2017, the grant date. |
5. These stock options vest in 48 equal monthly installments on each monthly anniversary following February 1, 2018, the grant date. |
6. These stock options vest in 48 equal monthly installments on each monthly anniversary following February 1, 2019, the grant date. |
7. On February 1, 2018, the reporting person was granted 13,125 restricted stock units, which have vested and settled or will vest and settle in three equal installments on each of February 1, 2019, February 1, 2020, and February 1, 2021. |
8. Not applicable. |
9. Each restricted stock unit represents a contingent right to receive one share of Issuer common stock. |
Remarks: |
Title: Chief Technology and Innovation Officer, and Head of Research Exhibit 24.1: Limited Power of Attorney |
/s/ David C. Lubner, Attorney-in-Fact for Alonso Ricardo | 03/06/2019 | |
** 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. |