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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1. Name and Address of Reporting Person*
Donohue Ann K.

(Last) (First) (Middle)
480 ARSENAL WAY

(Street)
WATERTOWN MA 02472

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/07/2019
3. Issuer Name and Ticker or Trading Symbol
SELECTA BIOSCIENCES INC [ SELB ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Controller
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/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 Beneficially Owned
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 1,216 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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) (1) 03/22/2027 Common Stock 5,100 10.89 D
Stock Option (Right to Buy) (2) 06/15/2027 Common Stock 1,108 17.47 D
Stock Option (Right to Buy) (3) 06/11/2028 Common Stock 10,000 12.46 D
Stock Option (Right to Buy) (4) 01/06/2029 Common Stock 25,000 2.6 D
Explanation of Responses:
1. This option vested as to 25% on September 12, 2017. The remainder of the underlying shares vest in 36 equal monthly installments thereafter.
2. This option vested as to 25% on June 16, 2018. The remainder of the underlying shares vest in 36 equal monthly installments thereafter.
3. This option will vest as to 25% on June 12, 2019. The remainder of the underlying shares will vest in 36 equal monthly installments thereafter.
4. This option will vest as to 25% on January 7, 2020. The remainder of the underlying shares vest in 36 equal monthly installments thereafter.
Remarks:
Ann K. Donohue 05/15/2019
** 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.
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