UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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 control number. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Preferred Stock | (1) | (1) | Common Stock | 22,500 | $ (1) | I | See Footnote (2) |
Series B Preferred Stock | (1) | (1) | Common Stock | 10,975 | $ (1) | I | See Footnote (2) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Gallagher Carol Giltner C/O ATARA BIOTHERAPEUTICS, INC. 3260 BAYSHORE BOULEVARD BRISBANE, CA 94005 |
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/s/ Tina Gullotta, Attorney-in-Fact for Carol G. Gallagher | 10/15/2014 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Each share of preferred stock will automatically convert into one share of the Issuer's common stock upon the closing of the Issuer's initial public offering. The shares have no expiration date. |
(2) | Shares held by Gallagher Revocable Trust, of which the Reporting Person is Trustee. |
Remarks: As described in the issuer's registration statement on Form S-1 (File No. 333-196936) for the issuer's initial public offering (the "IPO"), the Reporting Person holds 82,723 restricted stock units(the "RSUs"), the vesting of which are subject to the satisfaction of both (a) a service-based condition and (b) a liquidity event-based condition. As a result, RSUs are not yet considered reportable for purposes of Section 16, and are not reflected on this Form 3. The liquidity event-based condition of the RSUs will be satisfied upon the closing of the IPO. |