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*
Blum Michael Lee

(Last) (First) (Middle)
C/O HOMOLOGY MEDICINES, INC.
ONE PATRIOTS PARK

(Street)
BEDFORD MA 01730

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/02/2022
3. Issuer Name and Ticker or Trading Symbol
Homology Medicines, Inc. [ FIXX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Commercial 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)
Common Stock 6,780 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
Employee Stock Option (Right to Buy) (1) 12/07/2027 Common Stock 30,700 $6.6314 D
Employee Stock Option (Right to Buy) (2) 03/14/2029 Common Stock 18,700 $26.26 D
Employee Stock Option (Right to Buy) (3) 12/11/2029 Common Stock 60,000 $19.92 D
Employee Stock Option (Right to Buy) (4) 02/05/2031 Common Stock 49,000 $13.78 D
Employee Stock Option (Right to Buy) (5) 02/24/2032 Common Stock 92,000 $2.71 D
Restricted Stock Unit (6) (6) Common Stock 5,360 $0.00 D
Restricted Stock Unit (7) (7) Common Stock 15,000 $0.00 D
Explanation of Responses:
1. The option is fully vested.
2. The option vests in 48 substantially equal monthly installments on the first day of each calendar month following January 1, 2019.
3. The option vests in 48 substantially equal monthly installments on the first day of each calendar month following January 1, 2020.
4. The option vests in 48 substantially equal monthly installments on the first day of each calendar month following January 1, 2021.
5. The option vests in 48 substantially equal monthly installments on the first day of each calendar month following January 1, 2022.
6. The restricted stock units will vest and settle as to approximately one half of the restricted stock units on each January 1, 2023 and January 1, 2024. Each restricted stock unit represents a contingent right to receive one share of Issuer common stock. The restricted stock units have no expiration date.
7. The restricted stock units will vest and settle as to approximately one third of the restricted stock units on each of the first three anniversaries of January 1, 2022 so that such RSUs will become fully vested on January 1, 2025. Each restricted stock unit represents a contingent right to receive one share of Issuer common stock. The restricted stock units have no expiration date.
Remarks:
Exhibit 24 - Power of Attorney.
/s/ W. Bradford Smith, Attorney-in-Fact for Michael L. Blum 03/11/2022
** 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.