0001209191-23-000211.txt : 20230103 0001209191-23-000211.hdr.sgml : 20230103 20230103162643 ACCESSION NUMBER: 0001209191-23-000211 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20230101 FILED AS OF DATE: 20230103 DATE AS OF CHANGE: 20230103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clancy Annette CENTRAL INDEX KEY: 0001959700 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37993 FILM NUMBER: 23502465 MAIL ADDRESS: STREET 1: C/O OBSEVA SA STREET 2: CHEMIN DES AULX, 12, 1228 PLAN-LES-OUATE CITY: GENEVA STATE: V8 ZIP: 1228 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ObsEva SA CENTRAL INDEX KEY: 0001685316 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: V8 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: CHEMIN DES AULX, 12 CITY: PLAN-LES-OUATES STATE: V8 ZIP: 1228 BUSINESS PHONE: 0041-0-22-552-1558 MAIL ADDRESS: STREET 1: CHEMIN DES AULX, 12 CITY: PLAN-LES-OUATES STATE: V8 ZIP: 1228 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2023-01-01 0 0001685316 ObsEva SA OBSV 0001959700 Clancy Annette C/O OBSEVA SA C/O CHEMIN DES AULX, 12, PLAN-LES-OUATES GENEVA V8 1228 SWITZERLAND 1 0 0 0 Common Stock 97500 D Stock Option (right to buy) 15.00 2027-01-24 Common Stock 9000 D Stock Option (right to buy) 9.49 2027-12-06 Common Stock 23070 D Stock Option (right to buy) 13.45 2028-11-26 Common Stock 24570 D Stock Option (right to buy) 3.84 2030-01-27 Common Stock 24570 D Stock Option (right to buy) 3.76 2031-02-03 Common Stock 24570 D Stock Option (right to buy) 1.43 2032-02-01 Common Stock 32000 D Fully vested and exercisable. The shares underlying the option vested or will vest in 12 equal monthly installments from February 2, 2022, such that the option is fully vested on the one-year anniversary thereof, subject to the Reporting Person continuing to provide service through each such date. Exhibit List - Exhibit 24 - Power of Attorney /s/ Jason Minio, Attorney-in-Fact 2023-01-03 EX-24 2 poa.txt POA DOCUMENT Exhibit 24 POWER OF ATTORNEY (For Executing Form ID and Forms 3, 4 and 5) Know all by these presents, that the undersigned hereby constitutes and appoints each of Brian O'Callaghan and William M. Brown of ObsEva SA (the "Company") and Ryan Sansom, Su Lian Lu, Jonathan Robertson, Pengli Li, Ibe Alozie, Trevor Bossi and Jason Minio of Cooley LLP, signing individually, the undersigned's true and lawful attorneys-in-fact and agents to: (1) Prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the Securities and Exchange Commission (the "SEC"), a Form ID and Forms 3, 4 and 5 (including amendments thereto and joint filing agreements in connection therewith) in accordance with Section 16 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and the rules thereunder, in the undersigned's capacity as an officer, director or beneficial owner of more than 10% of a registered class of securities of the Company; (2) Do and perform any and all acts for and on behalf of the undersigned that may be necessary or desirable to prepare and execute any such Form ID and Forms 3, 4 or 5 (including amendments thereto and joint filing agreements in connection therewith) and file such forms with the SEC and any stock exchange, self-regulatory association or any similar authority; and (3) Take any other action of any type whatsoever in connection with the foregoing that, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required of the undersigned, it being understood that the documents executed by the 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 the attorney-in-fact may approve in the 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 or revocation, hereby ratifying and confirming all that such attorney in fact, or such attorney in fact's 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, and their substitutes, 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 Exchange Act. This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) 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 the Company, (b) revocation by the undersigned in a signed writing delivered to the Company and the foregoing attorneys-in fact or (c) as to any attorney-in-fact individually, until such attorney-in-fact is no longer employed by the Company or employed by or a partner at Cooley LLP or another law firm representing the Company, as applicable. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of the date written below. Date: 09-Dec-2022 /s/ Annette Clancy Annette Clancy