0001209191-23-037363.txt : 20230615
0001209191-23-037363.hdr.sgml : 20230615
20230615163540
ACCESSION NUMBER: 0001209191-23-037363
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230613
FILED AS OF DATE: 20230615
DATE AS OF CHANGE: 20230615
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SANDELL SCOTT D
CENTRAL INDEX KEY: 0001237289
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38981
FILM NUMBER: 231017914
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Mirum Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001759425
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 831281555
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 950 TOWER LANE, SUITE 1050
CITY: FOSTER CITY
STATE: CA
ZIP: 94404
BUSINESS PHONE: 650-667-4085
MAIL ADDRESS:
STREET 1: 950 TOWER LANE, SUITE 1050
CITY: FOSTER CITY
STATE: CA
ZIP: 94404
4
1
doc4.xml
FORM 4 SUBMISSION
X0407
4
2023-06-13
1
0001759425
Mirum Pharmaceuticals, Inc.
MIRM
0001237289
SANDELL SCOTT D
1954 GREENSPRING DRIVE
SUITE 600
TIMONIUM
MD
21093
0
0
1
0
0
Common Stock
2023-06-13
4
J
0
2000000
0.00
D
2186243
I
See Note 2
Common Stock
2023-06-13
4
J
0
30000
0.00
A
30000
I
See Note 4
Common Stock
2023-06-13
4
J
0
30000
0.00
D
0
I
See Note 4
Common Stock
2023-06-13
4
J
0
1455
0.00
A
1455
I
See Note 7
Common Stock
2023-06-13
4
J
0
163
0.00
A
163
I
See Note 9
Common Stock
2023-06-13
4
J
0
163
0.00
A
163
I
See Note 11
Common Stock
2023-06-13
4
J
0
11348
0.00
A
11348
I
See Note 13
New Enterprise Associates 16, L.P. ("NEA 16") made a pro rata distribution of 2,000,000 shares of Common Stock of the Issuer to its general partner and limited partners for no consideration on June 13, 2023.
The Reporting Person is a manager of NEA 16 GP, LLC ("NEA 16 GP"), which is the sole general partner of NEA Partners 16, L.P. ("NEA Partners 16"). NEA Partners 16 is the sole general partner of NEA 16, the direct beneficial owner of the securities. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the securities held by NEA 16 in which the Reporting Person has no pecuniary interest.
NEA Partners 16 received 30,000 shares of Common Stock of the Issuer in the distribution made by NEA 16 on June 13, 2023.
The Reporting Person is a manager of NEA 16 GP, which is the sole general partner of NEA Partners 16, the direct beneficial owner of the securities. The Reporting Person disclaims beneficial ownership within the meaning of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the securities held by NEA Partners 16 in which the Reporting Person has no pecuniary interest.
NEA Partners 16 made a pro rata distribution for no consideration of an aggregate of 30,000 shares of Common Stock of the Issuer to its limited partners on June 13, 2023.
The Reporting Person, as trustee of the Blue Mountain Trust, dated April 29, 2019 (the "Blue Mountain Trust"), received 1,455 shares of Common Stock of the Issuer in the distribution by NEA Partners 16 on June 13, 2023.
The Reporting Person is the trustee of the Blue Mountain Trust, which is the direct beneficial owner of the securities. The Reporting Person
disclaims beneficial ownership within the meaning of Section 16 of the 1934 Act, as amended, or otherwise of such portion of the securities
held by the Blue Mountain Trust in which the Reporting Person has no pecuniary interest.
Genevieve P. Hardigg, as trustee of the Scott Sandell Rising River Trust, dated December 20, 2012 (the "Scott Sandell Rising River Trust"),
received 163 shares of Common Stock of the Issuer in the distribution by NEA Partners 16 on June 13, 2023.
The securities are held directly by the Scott Sandell Rising River Trust. The Reporting Person disclaims beneficial ownership within the
meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the securities held by the Scott
Sandell Rising River Trust in which the Reporting Person has no pecuniary interest.
Genevieve P. Hardigg, as trustee of the Jennifer Ayer Sandell Rising River Trust, dated December 20, 2012 (the "Jennifer Sandell Rising River
Trust"), received 163 shares of Common Stock of the Issuer in the distribution by NEA Partners 16 on June 13, 2023.
The securities are held directly by the Jennifer Sandell Rising River Trust. The Reporting Person disclaims beneficial ownership within the
meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the securities held by the Jennifer
Sandell Rising River Trust in which the Reporting Person has no pecuniary interest.
NEA Investment Holdings CF, LLC ("NEA Holdings CF"), the managing member of NEA Investments TC, LLC ("NEA Investments TC"), received 11,348 shares of Common Stock of the Issuer in a distribution by NEA Investments TC on June 13, 2023. NEA Investments TC received the shares in a distribution from its wholly owned subsidiary, New Enterprise Associates, LLC, which shares were received in the distribution by NEA Partners 16 on June 13, 2023.
The Reporting Person is a member of the Board of Directors of NEA Holdings CF, the direct beneficial owner of the securities. The Reporting
Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of
such portion of the securities held by NEA Holdings CF in which the Reporting Person has no pecuniary interest.
/s/ Louis Citron, attorney-in-fact
2023-06-15