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*
Clements Ian

(Last) (First) (Middle)
C/O MIRUM PHARMACEUTICALS, INC.
950 TOWER LANE, SUITE 1050

(Street)
FOSTER CITY CA 94404

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/17/2019
3. Issuer Name and Ticker or Trading Symbol
Mirum Pharmaceuticals, Inc. [ MIRM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP Finance & Communications
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)
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) 03/13/2029 Common Stock 93,750 $2.936 D
Stock Option (right to buy) (2) 05/13/2029 Common Stock 65,625 $6.272 D
Explanation of Responses:
1. 1/4th of the shares vest one year after March 12, 2019, and the balance of the shares vest in a series of 36 successive equal monthly installments at the end of each month thereafter. The shares subject to this option are early exercisable, subject to the Issuer's right of repurchase.
2. 1/4th of the shares vest one year after April 12, 2019 and the balance of the shares vest in a series of 36 successive equal monthly installments measured from the first anniversary of April 12, 2019. The shares subject to this option are early exercisable, subject to the Issuer's right of repurchase.
Remarks:
/s/ Jody Howe, Attorney-in-Fact 07/17/2019
** 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.
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.