0001104659-18-045660.txt : 20180718 0001104659-18-045660.hdr.sgml : 20180718 20180718084031 ACCESSION NUMBER: 0001104659-18-045660 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180716 FILED AS OF DATE: 20180718 DATE AS OF CHANGE: 20180718 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FORMELA JEAN FRANCOIS CENTRAL INDEX KEY: 0001030575 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37766 FILM NUMBER: 18957718 MAIL ADDRESS: STREET 1: C/O ATLAS VENTURE STREET 2: 890 WINTER STREET CITY: WALTHAM STATE: MA ZIP: 02451 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Intellia Therapeutics, Inc. CENTRAL INDEX KEY: 0001652130 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 364785571 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 40 ERIE STREET STREET 2: SUITE 130 CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 857-285-6200 MAIL ADDRESS: STREET 1: 40 ERIE STREET STREET 2: SUITE 130 CITY: CAMBRIDGE STATE: MA ZIP: 02139 4 1 a4.xml 4 X0306 4 2018-07-16 0 0001652130 Intellia Therapeutics, Inc. NTLA 0001030575 FORMELA JEAN FRANCOIS C/O INTELLIA THERAPEUTICS, INC. 40 ERIE STREET, SUITE 130 CAMBRIDGE MA 02139 1 0 0 0 Common Stock 2018-07-16 4 S 0 5284 30.9680 D 1402 I See Footnote Common Stock 2018-07-16 4 S 0 1402 31.9275 D 0 I See Footnote Common Stock 1615321 I See Footnote Represents shares sold by Atlas Venture Associates IX, L.P. ("AVA IX LP"), which is the general partner of Atlas Venture Fund IX, L.P. (the "Fund"). On July 16, 2018 AVA IX LP received 6,868 shares of the issuer's common stock from the Fund in accordance with the exemptions afforded by Rule 16a-9 and Rule 16a-13 of the Securities Exchange Act of 1934, as amended (the "Act"). Atlas Venture Associates IX, LLC ("AVA IX LLC") is the general partner of AVA IX LP. Dr. Formela is a member of AVA IX LLC and disclaims Section 16 beneficial ownership of such shares, except to the extent of his pecuniary interest therein, if any. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $30.56 - $31.55, inclusive. The reporting person undertake to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in footnote (2) of this Form 4. The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by AVA IX LP on March 23, 2018. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $31.56 - $32.27, inclusive. The reporting person undertake to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in footnote (3) of this Form 4. The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by AVA IX LP on March 23, 2018. Represents shares held directly by the Fund. The general partner of the Fund is AVA IX LP. AVA IX LLC is the general partner of AVA IX LP. Dr. Formela is a member of AVA IX LLC and disclaims Section 16 beneficial ownership of such shares, except to the extent of his pecuniary interest therein, if any. Exhibit 24 - Power of Attorney (incorporated by reference to Exhibit 24, Power of Attorney, filed on Form 4 with the SEC on March 13, 2017 by the reporting person) By: /s/ Frank Castellucci, Attorney-In-Fact 2018-07-18