Ownership Submission
FORM 4
|
Check this box if no longer subject to Section 16, Form 4 or Form 5 obligations may continue. See Instruction 1(b).
|
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549STATEMENT OF CHANGES IN 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
|
OMB APPROVAL
|
OMB Number:3235-0287Expires:January 31, 2005Estimated average burden hours per response...0.5
|
|
1. Name and Address of Reporting Person *
|
Samuels Camille D
|
|
2. Issuer Name and Ticker or Trading Symbol
Unity Biotechnology, Inc. [UBX]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director
|
_____ 10% Owner
|
_____ Officer (give title below)
|
_____ Other (specify below)
|
|
|
(Last)
|
(First)
|
(Middle)
|
C/O UNITY BIOTECHNOLOGY, INC. , 285 EAST GRAND AVENUE
|
|
3. Date of Earliest Transaction (Month/Day/Year)
|
(Street)
|
SOUTH SAN FRANCISCO
|
CA
|
94080
|
|
4. If Amendment, Date Original Filed(Month/Day/Year)
|
6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
|
1.Title of Security
|
2. Transaction Date (Month/Day/Year)
|
2A. Deemed Execution Date, if any (Month/Day/Year)
|
3. Transaction Code
|
4. Securities Acquired (A) or Disposed of (D)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
|
6. Ownership Form: Direct (D) or Indirect (I)
|
7. Nature of Indirect Beneficial Ownership
|
Code
|
V
|
Amount
|
(A) or (D)
|
Price
|
|
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
|
2. Conversion or Exercise Price of Derivative Security
|
3. Transaction Date (Month/Day/Year)
|
3A. Deemed Execution Date, if any (Month/Day/Year)
|
4. Transaction Code
|
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
|
6. Date Exercisable and Expiration Date
|
7. Title and Amount of Securities Underlying Derivative Security
|
8. Price of Derivative Security
|
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s)
|
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
|
11. Nature of Indirect Beneficial Ownership
|
Code
|
V
|
(A)
|
(D)
|
Date Exercisable
|
Expriation Date
|
Title
|
Amount or Number of Shares
|
Reporting Owners
Reporting Owner Name / Address
|
Relationships
|
Director
|
10% Owner
|
Officer
|
Other
|
Samuels Camille D
C/O UNITY BIOTECHNOLOGY, INC.
285 EAST GRAND AVENUE
SOUTH SAN FRANCISCO, CA94080
|
X
|
|
|
|
Signatures
/s/ Alexander Nguyen, Attorney-in-Fact for Camille D. Samuels
|
2022-06-27
|
**Signature of Reporting Person
|
Date
|
Explanation of Responses:
(*)
|
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)
|
The underlying shares subject to the option vest and become exercisable as to 100% of the total number of shares subject to the option on the earlier of (i) the one-year anniversary measured from June 24, 2022 or (ii) the date of the 2023 Annual Meeting of the Issuer's stockholders, assuming continuous service as a Director until such vesting date.
|
(2)
|
The reporting person is a member of VR Management, LLC (the "Management Company"). Under an agreement between the reporting person and the Management Company, the reporting person is deemed to hold the reported option and the shares underlying the option for the sole benefit of the Management Company and must exercise the reported option solely upon the direction of the Management Company, which is entitled to the shares underlying the option. The Management Company may be deemed the indirect beneficial owner of the shares underlying the option, and the reporting person may be deemed the indirect beneficial owner of the reported shares underlying the option through her interest in the Management Company. The reporting person disclaims beneficial ownership of the reported shares except to the extent of her pecuniary interest therein.
|
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.