Initial Statement of Beneficial Ownership (3)
January 03 2023 - 5:01PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
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3235-0104
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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
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Savage William Jacob |
2. Date of Event Requiring Statement (MM/DD/YYYY)
12/29/2022
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3. Issuer Name and Ticker or Trading Symbol
Disc Medicine, Inc. [IRON]
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(Last)
(First)
(Middle)
C/O DISC MEDICINE, INC., 321 ARSENAL STREET, SUITE 101 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
Chief Medical Officer / |
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(Street)
WATERTOWN, MA 02472
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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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 | 20325 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 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) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Stock Option (Right to Buy) | (1) | 8/10/2030 | Common Stock | 20326 | $2.65 | D | |
| Stock Option (Right to Buy) | (2) | 10/22/2030 | Common Stock | 10275 | $2.65 | D | |
| Stock Option (Right to Buy) | (3) | 9/13/2031 | Common Stock | 45192 | $9.86 | D | |
| Stock Option (Right to Buy) | (4) | 9/13/2031 | Common Stock | 10521 | $9.86 | D | |
| Explanation of Responses: |
| (1) | 25% of the 40,651 shares originally underlying this option vested on August 3, 2021, with the remaining shares vesting in 36 equal monthly installments thereafter, subject to the Reporting Person's continued service on each such vesting date. The Reporting Person previously partially exercised this option. |
| (2) | 2,140 shares underlying this option vested on August 3, 2021, with the remaining shares vesting in 38 equal monthly installments thereafter, subject to the Reporting Person's continued service on each such vesting date. |
| (3) | The shares underlying this option vest in 48 equal monthly installments following September 1, 2021, subject to the Reporting Person's continued service on each such vesting date. |
| (4) | The shares underlying this option vest in 48 equal monthly installments following July 1, 2021, subject to the Reporting Person's continued service on each such vesting date. |
Remarks:
Exhibit 24 - Power of Attorney |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Savage William Jacob
C/O DISC MEDICINE, INC.
321 ARSENAL STREET, SUITE 101
WATERTOWN, MA 02472 |
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| Chief Medical Officer |
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Signatures
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| /s/ Rahul Khara, attorney-in-fact | | 1/3/2023 |
| **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 control number. |
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