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Filing
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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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/21/2024 |
3. Issuer Name and Ticker or Trading Symbol
Savara Inc [ SVRA ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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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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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 354,078(1) | D |
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) | 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: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option (Right to Buy) | (2) | 10/18/2028 | Common Stock | 20,000 | 10.01 | D | |
Stock Option (Right to Buy) | (3) | 05/30/2029 | Common Stock | 2,000 | 11 | D | |
Stock Option (Right to Buy) | (4) | 12/17/2029 | Common Stock | 25,000 | 1.57 | D | |
Stock Option (Right to Buy) | (5) | 10/21/2030 | Common Stock | 75,000 | 1.13 | D | |
Stock Option (Right to Buy) | (6) | 12/16/2030 | Common Stock | 50,000 | 1.23 | D | |
Stock Option (Right to Buy) | (7) | 12/14/2031 | Common Stock | 50,000 | 1.11 | D | |
Stock Option (Right to Buy) | (8) | 12/13/2032 | Common Stock | 150,000 | 1.51 | D | |
Stock Option (Right to Buy) | (9) | 12/14/2033 | Common Stock | 40,000 | 4.45 | D |
Explanation of Responses: |
1. 4,687 represents restricted stock units ("RSUs") that vest in substantially equal installments on April 21, 2024, July 21, 2024, and October 21, 2024; 75,000 represents RSUs that vest in full on December 13, 2024; and 160,000 represents RSUs that vest in full on December 14, 2025, in each case subject to the reporting person's continued service with the Issuer. Each RSU represents a contingent right to receive one share of the Issuer's common stock. |
2. The option vests and becomes exercisable in sixteen equal installments on each quarterly anniversary of October 18, 2018, subject to the reporting person's continued service with the Issuer. |
3. The option vests and becomes exercisable in sixteen equal installments on each quarterly anniversary of May 30, 2019, subject to the reporting person's continued service with the Issuer. |
4. The option vests and becomes exercisable in sixteen equal installments on each quarterly anniversary of December 17, 2019, subject to the reporting person's continued service with the Issuer. |
5. The option vests and becomes exercisable in sixteen equal installments on each quarterly anniversary of October 21, 2020, subject to the reporting person's continued service with the Issuer. |
6. The option vests and becomes exercisable in sixteen equal installments on each quarterly anniversary of December 16, 2020, subject to the reporting person's continued service with the Issuer. |
7. The option vests and becomes exercisable in sixteen equal installments on each quarterly anniversary of December 14, 2021, subject to the reporting person's continued service with the Issuer. |
8. The option vests and becomes exercisable in sixteen equal installments on each quarterly anniversary of December 13, 2022, subject to the reporting person's continued service with the Issuer. |
9. The option vests and becomes exercisable in sixteen equal installments on each quarterly anniversary of December 14, 2023, subject to the reporting person's continued service with the Issuer. |
/s/ Anne Erickson | 03/28/2024 | |
** 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 FOR SECTION 16(a) REPORTING
KNOW ALL PERSONS BY THESE PRESENTS, that the undersigned hereby makes, constitutes and appoints each of David L. Lowrance and Kathleen R. McCabe, and each of their successors in the offices of Chief Financial & Administrative Officer or Senior Vice President and General Counsel of Savara Inc. (the “Company”), as the undersigned's true and lawful attorney-in-fact (the “Attorney-in Fact”), with full power of substitution and resubstitution, each with the power to act alone for the undersigned and in the undersigned's name, place and stead, in any and all capacities to:
The undersigned acknowledges that:
The undersigned hereby grants to the Attorney-in-Fact full power and authority to do and perform each and every act and thing requisite, necessary or convenient to be done in connection with the foregoing, as fully, to all intents and purposes, as the undersigned might or could do in person, hereby ratifying and confirming all that the Attorney-in-Fact, or his or her substitute or substitutes, shall lawfully do or cause to be done by authority of this Limited Power of Attorney. This Limited Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 or 5 with
respect to the undersigned's holdings of and transactions in equity securities of the Company, unless earlier revoked by the undersigned in a signed writing delivered to the Attorney-in-Fact. This Limited Power of Attorney shall be governed and construed in accordance the laws of the State of Texas without
regard to the laws that might otherwise govern under applicable principles of conflicts of laws thereof.
(Signature page follows.)
IN WITNESS WHEREOF, the undersigned has caused this Limited Power of Attorney for Section 16(a) Reporting to be executed as of March 28, 2024.
Signature: ____/s/ Anne Erickson____________
Print Name: __Anne Erickson________________