0000903423-16-001321.txt : 20161026 0000903423-16-001321.hdr.sgml : 20161026 20161026175130 ACCESSION NUMBER: 0000903423-16-001321 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161024 FILED AS OF DATE: 20161026 DATE AS OF CHANGE: 20161026 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CRISPR Therapeutics AG CENTRAL INDEX KEY: 0001674416 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 473173478 BUSINESS ADDRESS: STREET 1: 200 SIDNEY STREET CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 6173154600 MAIL ADDRESS: STREET 1: 200 SIDNEY STREET CITY: CAMBRIDGE STATE: MA ZIP: 02139 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: George Simeon CENTRAL INDEX KEY: 0001595117 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37923 FILM NUMBER: 161953475 MAIL ADDRESS: STREET 1: 161 WASHINGTON STREET STREET 2: SUITE 500 CITY: CONSHOHOCKEN STATE: PA ZIP: 19428 4 1 george-crispr.xml OWNERSHIP DOCUMENT X0306 4 2016-10-24 0 0001674416 CRISPR Therapeutics AG CRSP 0001595117 George Simeon C/O S.R. ONE, LIMITED 161 WASHINGTON STREET, SUITE 500 CONSHOHOCKEN PA 19428 1 0 0 0 Common Shares 2016-10-24 4 C 0 2942560 A 2942560 I See explanation of responses Common Shares 2016-10-24 4 C 0 211567 A 3154127 I See explanation of responses Common Shares 2016-10-24 4 P 0 66500 14.00 A 3220627 I See explanation of responses Series A-3 Preferred Shares 2016-10-24 4 C 0 2942560 0 D Common Shares 2942560 0 I See explanation of responses Series B Preferred Shares 2016-10-24 4 C 0 211567 0 D Common Shares 211567 0 I See explanation of responses On October 24, 2016, S.R. One, Limited ("S.R. One") acquired 66,500 common shares of the Issuer ("Common Shares") at a price of $14.00 per share in connection with the Issuer's initial public offering. These shares are held of record by S.R. One, Limited, an indirect, wholly-owned subsidiary of GlaxoSmithKline plc. Simeon J. George (the "Reporting Person") is a Vice President at S.R. One, Limited and an employee of GlaxoSmithKline LLC, an indirect, wholly-owned subsidiary of GlaxoSmithKline plc. The Reporting Person disclaims beneficial ownership of all the shares herein and this report shall not be deemed an admission of beneficial ownership of such shares for the purposes of Section 16 or for any other purpose except to the extent of his proportionate pecuniary interest therein, if any. On October 24, 2016, the Series A-3 Preferred Shares and the Series B Preferred Shares converted automatically into Common Shares on a one-for-one basis, upon closing of the Issuer's initial public offering Not applicable. /s/ Simeon J. George 2016-10-26