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*
Kapusta Matthew C

(Last) (First) (Middle)
C/O UNIQURE N.V.
113 HARTWELL AVENUE

(Street)
LEXINGTON MA 02421

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2017
3. Issuer Name and Ticker or Trading Symbol
uniQure N.V. [ QURE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
CEO, CFO, Managing Director
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)
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
Stock Option (right to buy) (1) 09/29/2026 Ordinary Shares 100,000 $7.55 D
Performance Share Units (2) (3) Ordinary Shares 23,064 $0 D
Stock Option (right to buy) (4) 01/02/2025 Ordinary Shares 100,000 $14.71 D
Stock Option (right to buy) (5) 08/25/2025 Ordinary Shares 100,000 $23.6 D
Performance Share Units (6) (7) Ordinary Shares 61,560 $0 D
Explanation of Responses:
1. The Stock Option vests 25% on September 29, 2017 and 6.25% quarterly thereafter until fully vested.
2. Performance Shares Units of a maximum of 23,064 shares of the Company's Ordinary Shares were granted on January 28, 2016. The Board of Directors shall determine how many Performance Share Units are to be granted in conjunction with a review of certain performance goals associated with the grant. Any such Performance Share Units granted by the Board of Directors shall vest 100% on January 27, 2019.
3. Expiration date is not applicable.
4. The Stock Option vests 25% on January 2, 2016 and 6.25% quarterly thereafter until fully vested.
5. The Stock Option vests 25% on August 25, 2016 and 6.25% quarterly thereafter until fully vested.
6. Performance Shares Units of a maximum of 61,560 shares of the Company's Ordinary Shares were granted on September 29, 2016. The Board of Directors shall determine how many Performance Share Units are to be granted in conjunction with a review of certain performance goals associated with the grant. Any such Performance Share Units granted by the Board of Directors shall vest 100% on December 31, 2017.
7. Expiration date is not applicable.
Remarks:
See Exhibit 24 - Power of Attorney
/s/Lauren M. Watson, Attorney-in-Fact 01/05/2017
** 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.