SEC FORM
3
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
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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
C/O BEAM THERAPEUTICS INC. |
238 MAIN STREET |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/16/2023
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3. Issuer Name and Ticker or Trading Symbol
Beam Therapeutics Inc.
[ BEAM ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
Chief Legal Officer |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Common Stock |
58,441
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D |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Stock Option (Right to Buy) |
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03/31/2031 |
Common Stock |
23,959
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80.04 |
D |
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Stock Option (Right to Buy) |
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01/31/2032 |
Common Stock |
30,000 |
69.21 |
D |
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Stock Option (Right to Buy) |
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01/31/2033 |
Common Stock |
35,000 |
43.45 |
D |
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Stock Option (Right to Buy) |
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05/16/2029 |
Common Stock |
19,946
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7.22 |
D |
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Stock Option (Right to Buy) |
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05/17/2029 |
Common Stock |
19,405
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7.22 |
D |
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Stock Option (Right to Buy) |
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08/31/2031 |
Common Stock |
10,000 |
110.92 |
D |
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Stock Option (Right to Buy) |
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12/30/2032 |
Common Stock |
25,000 |
39.11 |
D |
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Explanation of Responses: |
Remarks: |
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By: /s/ Christine Bellon |
03/27/2023 |
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** 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. |
LIMITED POWER OF ATTORNEY
The undersigned hereby constitutes and appoints John Evans, Terry-Ann
Burrell, and Jon Mahlowitz, and each of them individually, with full power of
substitution, 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 U.S. Securities and Exchange Commission
(the "SEC") a Form ID, including amendments thereto, and any other
documents necessary or appropriate to obtain 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, in the undersigned's
capacity as officer and/or director of Beam Therapeutics Inc. (the
"Company"), Forms 3, 4, 5 and any Schedules 13D or 13G in
accordance with Section 16(a) 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 that may be necessary or desirable to complete and
execute any such Form 3, 4, or 5 or Schedule 13D or 13G, 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 that, in the opinion of each 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 each such attorney-in-fact on behalf of t undersigned pursuant
to this Power of Attorney shall be in such form and shall contain
such tms and conditions as each such attorney-in-fact may approve
in each 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 whatsecessary, or
proper to be donen the exercise of any of the rights and powers herein granted,
as fullyallntents an purposes the undersigned might or could do if personally
present, with full poweofubitution or vocation, hereby ratiing and confirming
all that each such attorney-in-fact, or each such aney--facs substitute or
substitute shall lawfully do or cause to be done by virtue of this power of
atrneanthe rits and powers herein ted. The undersigned acknowledges that each
foregoing attorney-inact, inerng i such cacity at request of thendersigned, are
not assuming, nor is the Compa assungany the
ndersigned respoibities to comply
wh Section 16 of the Securities Exchange o1934as ameed.
This Pow of Attorn shall remain in fullorce and effect until the
undersigned is no longer required to file Forms 3, 4, 5, and any Schedules 13D
or 13G with respect to the undersigned's holdings of and transactions in
securities issued by the Company, unless earlier revoked by the undersigned in a
signed writing delivered to each foregoing attorney-in-fact.
[Remainder of page intentionally left blank]
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be executed as of this 22nd day of March, 2023
/s/ Christine Bellon
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Name: Christine Bellon
Signature Page to Limited Power of Attorney