Statement of Changes in Beneficial Ownership (4)
November 12 2021 - 05:47PM
Edgar (US Regulatory)
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. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
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APPROVAL
OMB Number: 3235-0287
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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
|
|
| 1. Name
and Address of Reporting Person * Dominy Stephen S. |
2. Issuer Name and Ticker or Trading
Symbol Cortexyme, Inc. [ CRTX ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Scientific Officer |
|
(Last)
(First)
(Middle)
C/O CORTEXYME, INC., 269 EAST GRAND AVE. |
3. Date of Earliest Transaction (MM/DD/YYYY)
11/12/2021
|
|
(Street)
SOUTH SAN FRANCISCO, CA 94080
(City)
(State)
(Zip)
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4. 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 |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
|
Code |
V |
Amount |
(A) or (D) |
Price |
|
Common Stock |
11/12/2021 |
|
P |
|
763 |
A |
$14.40 |
1217086 |
I |
By the Dominy Family Trust 2016 (1) |
|
Common Stock |
|
|
|
|
|
|
|
220588 |
I |
By The Stephen Dominy 2019 Annuity
Trust (2) |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially
Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr.
4) |
|
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of
Responses: |
| (1) |
Stephen S. Dominy is a
trustee of the Dominy Family Trust 2016, and shares voting and
dispositive power with one other trustee with respect to the shares
held of record by the Dominy Family Trust 2016. |
| (2) |
Stephen S. Dominy is the
trustee of the Stephen Dominy 2019 Annuity Trust, and has sole
voting and dispositive power with respect to the shares held of
record by the Stephen Dominy 2019 Annuity Trust. |
Reporting
Owners
|
|
Reporting Owner Name / Address |
Relationships
|
|
Director |
10% Owner |
Officer |
Other |
Dominy Stephen S.
C/O CORTEXYME, INC.
269 EAST GRAND AVE.
SOUTH SAN FRANCISCO, CA 94080 |
X |
|
Chief Scientific Officer |
|
Signatures
|
|
/s/ Caryn Gordon McDowell, as Attorney-in-Fact
for Stephen S. Dominy |
|
11/12/2021 |
| **Signature of Reporting
Person |
Date |
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