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*
601 LEXINGTON AVENUE |
54TH FLOOR |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/06/2019
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3. Issuer Name and Ticker or Trading Symbol
Alector, Inc.
[ ALEC ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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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)
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Form filed by One Reporting Person |
X |
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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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 |
Series A-1 Preferred Stock |
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Common Stock |
405,925 |
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I |
See footnotes
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Series A-1 Preferred Stock |
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Common Stock |
94,075 |
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I |
See footnotes
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Series A-2 Preferred Stock |
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Common Stock |
4,282,288 |
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I |
See footnotes
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Series A-2 Preferred Stock |
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Common Stock |
992,437 |
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I |
See footnotes
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Series B Preferred Stock |
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Common Stock |
2,029,626 |
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I |
See footnotes
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Series B Preferred Stock |
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Common Stock |
470,374 |
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I |
See footnotes
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Series C Preferred Stock |
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Common Stock |
2,280,479 |
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I |
See footnotes
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Series C Preferred Stock |
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Common Stock |
528,510 |
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I |
See footnotes
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Series D Preferred Stock |
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Common Stock |
1,012,282 |
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I |
See footnotes
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Series D Preferred Stock |
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Common Stock |
234,601 |
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I |
See footnotes
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Series E Preferred Stock |
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Common Stock |
266,437 |
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I |
See footnotes
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Series E Preferred Stock |
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Common Stock |
85,295 |
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I |
See footnotes
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1. Name and Address of Reporting Person*
601 LEXINGTON AVENUE |
54TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
601 LEXINGTON AVENUE |
54TH FLOOR |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Douglas Coon, attorney-in-fact |
02/06/2019 |
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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. |
ORBIMED ADVISORS LLC
POWER OF ATTORNEY
SECTIONS 13 AND 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned, OrbiMed Advisors LLC, hereby
constitutes and appoints Douglas Coon as its true and lawful agent and
attorney-in-fact, with full power of substitution and full power and authority
in the undersigned's name, place and stead, to:
(1) sign any and all instruments, certificates and documents that may be
necessary, desirable or appropriate to be executed on its behalf or in its
capacity as a managing member of any partnership or limited liability company,
pursuant to Section 13 or 16 of the Securities Exchange Act of 1934, as amended;
(2) file the same (including any amendments thereto), with all exhibits thereto,
and any other documents in connection therewith, with the Securities and
Exchange Commission, and any stock exchange or 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 the 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.
This power of attorney shall remain in full force and effect until revoked by
the undersigned in a signed writing delivered to the foregoing attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this power of attorney to be
executed as of the date written below.
Date: June 15, 2018
OrbiMed Advisors LLC
By: /s/ Jonathan T. Silverstein
Name: Jonathan T. Silverstein
Title: Member of OrbiMed Advisors LLC
By: /s/ Sven H. Borho
Name: Sven H. Borho
Title: Member of OrbiMed Advisors LLC
By: /s/ Carl L. Gordon
Name: Carl L. Gordon
Title: Member of OrbiMed Advisors LLC