0000899243-18-008647.txt : 20180327 0000899243-18-008647.hdr.sgml : 20180327 20180327175941 ACCESSION NUMBER: 0000899243-18-008647 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180327 FILED AS OF DATE: 20180327 DATE AS OF CHANGE: 20180327 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHAH MAHENDRA CENTRAL INDEX KEY: 0001255449 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38433 FILM NUMBER: 18716580 MAIL ADDRESS: STREET 1: 2250 HOLCOMBE BLVD CITY: HOUSTON STATE: TX ZIP: 77030 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Homology Medicines, Inc. CENTRAL INDEX KEY: 0001661998 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 473468154 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 45 WIGGINS AVE. CITY: BEDFORD STATE: MA ZIP: 01730 BUSINESS PHONE: 857-305-1825 MAIL ADDRESS: STREET 1: 45 WIGGINS AVE. CITY: BEDFORD STATE: MA ZIP: 01730 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-03-27 0 0001661998 Homology Medicines, Inc. FIXX 0001255449 SHAH MAHENDRA 505 HAMILTON STREET, SUITE 207 PALO ALTO CA 94301 1 0 0 0 Series B Preferred Stock Common Stock 659742 I See footnote The preferred stock will automatically convert into the Issuer's common stock on a one-for-one basis upon the closing of the Issuer's initial public offering and has no expiration date. The securities reported herein are held of record by Vivo Panda Fund, L.P. ("Vivo LP"). Vivo Panda, LLC ("Vivo LLC") is the sole general partner of Vivo LP. Mahendra G. Shah, Ph.D., is a managing member of Vivo LLC and has shared voting and investment power over the shares beneficially owned by Vivo LP and may therefore be deemed to have or share beneficial ownership of the Series B Preferred Stock held directly by Vivo LP. Each of Vivo LLC and Dr. Shah disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein. Exhibit 24 - Power of Attorney. /s/ Bradford Smith, Attorney-in-Fact for Mahendra G. Shah 2018-03-27 EX-24 2 attachment1.htm EX-24 DOCUMENT

                               POWER OF ATTORNEY

    With respect to holdings of and transactions in securities issued by
Homology Medicines, Inc. (the "Company"), the undersigned hereby constitutes and
appoints the individuals named on Schedule A attached hereto and as may be
amended from time to time, or any of them signing singly, with full power of
substitution and resubstitution, to act as the undersigned's true and lawful
attorney-in-fact to:

    1.  prepare, execute in the undersigned's name and on the undersigned's
        behalf, and submit to the United States Securities and Exchange
        Commission (the "SEC") a Form ID, including amendments thereto, and any
        other documents necessary or appropriate to obtain and/or regenerate
        codes and passwords enabling the undersigned to make electronic filings
        with the SEC of reports required by Section 16(a) of the Securities
        Exchange Act of 1934, as amended, or any rule or regulation of the SEC;

    2.  execute for and on behalf of the undersigned, Forms 3, 4, and 5 in
        accordance with Section 16 of the Securities Exchange Act of 1934, as
        amended, and the rules thereunder;

    3.  do and perform any and all acts for and on behalf of the undersigned
        which may be necessary or desirable to complete and execute any such
        Form 3, 4, or 5, complete and execute any amendment or amendments
        thereto, and timely file such form with the SEC and any stock exchange
        or similar authority; and

    4.  take any other action of any type whatsoever in connection with the
        foregoing which, in the opinion of such attorney-in-fact, may be of
        benefit to, in the best interest of, or legally required by, the
        undersigned, it being understood that the documents executed by such
        attorney-in-fact on behalf of the undersigned pursuant to this Power of
        Attorney shall be in such form and shall contain such terms and
        conditions as such attorney-in-fact may approve in such attorney-in-
        fact's discretion.

    The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution and
resubstitution or revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorneys-in-fact substitute or substitutes, shall
lawfully do or cause to be done by virtue of this Power of Attorney and the
rights and powers herein granted.

    The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Securities Exchange Act of 1934, as amended.

    This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by Homology
Medicines, Inc., unless earlier revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in- fact.

    IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 13th day of March, 2018.


                                        Signature:   /s/ Mahendra G. Shah, Ph.D.
                                                    ----------------------------
                                        Print Name: Mahendra G. Shah, Ph.D.


                                    Schedule A
                                    ----------

    Individuals Appointed as Attorney-in-Fact with Full Power of Substitution
and Resubstitution:


Arthur Tzianabos, Ph.D.
Bradford Smith
CJ Witalisz