0001127602-22-012938.txt : 20220502 0001127602-22-012938.hdr.sgml : 20220502 20220502202436 ACCESSION NUMBER: 0001127602-22-012938 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220428 FILED AS OF DATE: 20220502 DATE AS OF CHANGE: 20220502 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AFEYAN NOUBAR CENTRAL INDEX KEY: 0001222012 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38753 FILM NUMBER: 22884082 MAIL ADDRESS: STREET 1: C/O FLAGSHIP PIONEERING, INC. STREET 2: 55 CAMBRIDGE PARKWAY, SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Moderna, Inc. CENTRAL INDEX KEY: 0001682852 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 813467528 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 200 TECHNOLOGY SQUARE CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 6177146500 MAIL ADDRESS: STREET 1: 200 TECHNOLOGY SQUARE CITY: CAMBRIDGE STATE: MA ZIP: 02139 FORMER COMPANY: FORMER CONFORMED NAME: Moderna Therapeutics, Inc. DATE OF NAME CHANGE: 20160822 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2022-04-28 0001682852 Moderna, Inc. MRNA 0001222012 AFEYAN NOUBAR 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 1 Common Stock 2022-04-28 4 M 0 703 0 A 2239673 D Common Stock 3924 I By: Flagship Pioneering, Inc. Common Stock 11460435 I By: Flagship Venture Labs IV LLC Common Stock 3276339 I By: Flagship Ventures Fund IV, LP Common Stock 2840318 I By: Flagship Ventures Fund IV-Rx, LP Stock Option (Right to Buy) 142.52 2022-04-28 4 A 0 5415 0 A 2032-04-28 Common Stock 5415 5415 D Restricted Stock Units 0 2022-04-28 4 M 0 703 0 D Common Stock 703 0 D Restricted stock units convert into common stock on a one-for-one basis. Securities held by Flagship Pioneering, Inc. ("Flagship Pioneering"). Noubar B. Afeyan, Ph.D. is the CEO and a stockholder of Flagship Pioneering. Each of the reporting persons except for Flagship Pioneering disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein. Shares held by Flagship VentureLabs IV LLC ("VentureLabs IV"). Flagship Ventures Fund IV, L.P. ("Flagship Fund IV") is a member of VentureLabs IV and also serves as its manager. Flagship Ventures Fund IV General Partner LLC ("Flagship Fund IV GP") is the general partner of Flagship Fund IV. Noubar B. Afeyan, Ph.D. is the sole the manager of Flagship Fund IV GP. Each of the reporting persons except for VentureLabs IV disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein. Shares held by Flagship Ventures Fund IV. Flagship Fund IV GP is the general partner of Flagship Fund IV. Noubar B. Afeyan, Ph.D. is the sole manager of Flagship Fund IV GP. Each of the reporting persons except for Flagship Fund IV disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein. Shares held by Flagship Ventures Fund IV-Rx, L.P. ("Flagship Fund IV-Rx"). Flagship Fund IV GP is the general partner of Flagship Fund IV-Rx. Noubar B. Afeyan, Ph.D. is the sole manager of Flagship Fund IV GP. Each of the reporting persons except for Flagship Fund IV-Rx disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein. This option will become fully vested and exercisable on the earlier of April 28, 2023, or Moderna's next Annual Meeting of Stockholders, subject to the recipient's continued service. The shares subject to this restricted stock unit award vested in full on April 28, 2022. /s/ Brian Sandstrom, as Attorney-in-Fact 2022-05-02