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*
Thorell Marella

(Last) (First) (Middle)
C/O CENTESSA PHARMACEUTICALS PLC
3RD FL., 1 ASHLEY RD, ALTRINCHAM

(Street)
CHESHIRE X0 WA14 2DT

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/27/2021
3. Issuer Name and Ticker or Trading Symbol
Centessa Pharmaceuticals plc [ CNTA ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Accounting Officer
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
Share Option (right to buy) (1) 09/30/2030 Ordinary Shares(2)(3) 58,956 $4.11 D
Share Option (right to buy) (4) 12/30/2030 Ordinary Shares(2)(3) 9,487 $4.87 D
Share Option (right to buy) (5) 02/19/2031 Ordinary Shares(2)(3) 208,474 $5.84 D
Explanation of Responses:
1. 56.25% of the shares subject to such option are vested as of January 29, 2021. The remaining 43.75% of the shares subject to such option shall vest and become exercisable monthly beginning on February 1, 2021.
2. Represents A Ordinary Shares that will be redesignated as Ordinary Shares immediately prior to the closing of the initial public offering.
3. Ordinary Shares may be represented by American Depositary Shares, each of which currently represents one Ordinary Share.
4. 25% of the shares subject to such option are vested as of January 29, 2021. The remaining 75% of the shares subject to such option shall vest and become exercisable monthly beginning on February 1, 2021.
5. 25% of the shares subject to such option shall vest and become exercisable on February 19, 2022 and the remaining 75% of the shares subject to such option shall vest and become exercisable in 36 monthly installments on the first day of each month thereafter.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Marella Thorell 05/27/2021
** 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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