0001209191-23-037361.txt : 20230615 0001209191-23-037361.hdr.sgml : 20230615 20230615163408 ACCESSION NUMBER: 0001209191-23-037361 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: Makhzoumi Mohamad CENTRAL INDEX KEY: 0001630226 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38981 FILM NUMBER: 231017887 MAIL ADDRESS: STREET 1: 2855 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 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 0001630226 Makhzoumi Mohamad 2855 SAND HILL ROAD MENLO PARK CA 94025 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 0 153 0.00 A 153 I See Note 7 Common Stock 2023-06-13 4 J 0 11348 0.00 A 11348 I See Note 9 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. Mohamad H. Makhzoumi and Katherine Makhzoumi, as Trustees of the Makhzoumi Family Trust dated February 11, 2016 (the "Makhzoumi Family Trust"), received 153 shares of Common Stock of the Issuer in the distribution made by NEA Partners 16 on June 13, 2023. The securities are held directly by the Makhzoumi Family 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 Makhzoumi Family 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