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*
2740 SAND HILL ROAD |
2ND FLOOR |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 11/02/2023
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3. Issuer Name and Ticker or Trading Symbol
Lexeo Therapeutics, Inc.
[ LXEO ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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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 convertible preferred stock |
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Common Stock |
1,793,429 |
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I |
By Longitude Venture Partners IV, L.P.
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Series B convertible preferred stock |
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Common Stock |
274,314
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I |
By Longitude Venture Partners IV, L.P.
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1. Name and Address of Reporting Person*
2740 SAND HILL ROAD |
2ND FLOOR |
(Street)
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1. Name and Address of Reporting Person*
2740 SAND HILL ROAD |
2ND FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O LONGITUDE CAPITAL |
2740 SAND HILL ROAD, 2ND FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O LONGITUDE CAPITAL |
2740 SAND HILL ROAD, 2ND FLOOR |
(Street)
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Explanation of Responses: |
Remarks: |
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Longitude Capital Partners IV, LLC By: /s/ Cristiana Blauth Oliveira , Authorized Signatory |
11/02/2023 |
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Longitude Venture Partners IV, L.P. By: /s/ Cristiana Blauth Oliveira , Authorized Signatory of the General Partner |
11/02/2023 |
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/s/ Cristiana Blauth Oliveira , Attorney-in-Fact for Juliet Tammenoms Bakker |
11/02/2023 |
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/s/ Cristiana Blauth Oliveira, Attorney-in-Fact for Patrick Enright |
11/02/2023 |
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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. |
EXHBIT 24
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and appoints
Cristiana Blauth Oliveira as the undersigned's true and lawful attorney-in-fact
(the "Attorney-in-Fact") to:
1. execute for and on behalf of the undersigned (the "Reporting Person") a Form
ID Application and/or "Update Passphrase Confirmation," if required, and submit
the same to the United States Securities and Exchange Commission (the
"Commission");
2. execute for and on behalf of the Reporting Person any and all reports,
notices, communications and other documents (including, but not limited to,
reports on Schedule 13D, Schedule 13G, Form 13-F, Form 3, Form 4 and Form 5)
that such Reporting Person may be required to file with the Commission pursuant
to the Securities Act of 1933, as amended, and the Securities Exchange Act of
1934, as amended (collectively, the "Reports") with respect to the Reporting
Person's (a) status as an officer or director of, or (b) ownership of, or
transactions in, securities of, any entity whose securities are beneficially
owned (directly or indirectly) by such Reporting Person (each, a "Company");
3. do and perform any and all acts for and on behalf of the Reporting Person
which may be necessary or desirable to complete and execute any such Reports and
timely file such forms and schedules with the Commission and any stock exchange
or similar authority; and
4. take any other action of any type whatsoever in connection with the foregoing
which, in the opinion of the 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 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 all and every act and thing whatsoever requisite, necessary,
and 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 the Attorney-in-Fact, or her 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 the
undersigned is no longer required to file Forms 3, 4 and 5, Form 13F or
Schedules 13G/D 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 the Attorney-in-Fact. The Reporting Person
acknowledges that the Attorney-in-Fact, in serving in such capacity at the
request of the undersigned, is not hereby assuming any of the undersigned's
responsibilities to comply with Section 13 or Section 16 of the Securities
Exchange Act of 1934 and state or federal securities laws. This Power of
Attorney may be filed with the Commission as a confirming statement of the
authority granted herein.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this March 15, 2023.
/s/ Juliet Tammenoms Bakker
Juliet Tammenoms Bakker
EXBIBIT 24.1
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and appoints
Cristiana Blauth Oliveira as the undersigned's true and lawful attorney-in-fact
(the "Attorney-in-Fact") to:
1. execute for and on behalf of the undersigned (the "Reporting Person") a Form
ID Application and/or "Update Passphrase Confirmation," if required, and submit
the same to the United States Securities and Exchange Commission (the
"Commission");
2. execute for and on behalf of the Reporting Person any and all reports,
notices, communications and other documents (including, but not limited to,
reports on Schedule 13D, Schedule 13G, Form 13-F, Form 3, Form 4 and Form 5)
that such Reporting Person may be required to file with the Commission pursuant
to the Securities Act of 1933, as amended, and the Securities Exchange Act of
1934, as amended (collectively, the "Reports") with respect to the Reporting
Person's (a) status as an officer or director of, or (b) ownership of, or
transactions in, securities of, any entity whose securities are beneficially
owned (directly or indirectly) by such Reporting Person (each, a "Company");
3. do and perform any and all acts for and on behalf of the Reporting Person
which may be necessary or desirable to complete and execute any such Reports and
timely file such forms and schedules with the Commission and any stock exchange
or similar authority; and
4. take any other action of any type whatsoever in connection with the foregoing
which, in the opinion of the 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 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 all and every act and thing whatsoever requisite, necessary,
and 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 the Attorney-in-Fact, or her 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 the
undersigned is no longer required to file Forms 3, 4 and 5, Form 13F or
Schedules 13G/D 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 the Attorney-in-Fact. The Reporting Person
acknowledges that the Attorney-in-Fact, in serving in such capacity at the
request of the undersigned, is not hereby assuming any of the undersigned's
responsibilities to comply with Section 13 or Section 16 of the Securities
Exchange Act of 1934 and state or federal securities laws. This Power of
Attorney may be filed with the Commission as a confirming statement of the
authority granted herein.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this March 15, 2023.
/s/ Patrick G. Enright
Patrick G. Enright