Sec Form 3 Filing - ROBINS HARLAN S @ Adaptive Biotechnologies Corp - 2019-06-26

Insider filing report for Changes in Beneficial Ownership
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FORM 3
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
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
ROBINS HARLAN S
2. Issuer Name and Ticker or Trading Symbol
Adaptive Biotechnologies Corp [ ADPT]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Scientific Officer
(Last) (First) (Middle)
C/O ADAPTIVE BIOTECHNOLOGIES CORPORATION, 1551 EASTLAKE AVE E STE 200
3. Date of Earliest Transaction (MM/DD/YY)
06/26/2019
(Street)
SEATTLE, WA98102
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction 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 300,000 ( 1 ) I By CMR 2014 Brother's Trust U/T/A dated July 2, 2014
Common Stock 500,000 ( 1 ) I By CMR 2014 Mother's Trust U/T/A dated July 2, 2014
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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
Stock Option (Right to Buy) $ 6.32 ( 2 ) 06/09/2025 Common Stock 600,000 D
Stock Option (Right to Buy) $ 6.55 ( 3 ) 02/07/2028 Common Stock 400,000 D
Stock Option (Right to Buy) $ 7.27 ( 4 ) 02/07/2029 Common Stock 410,000 D
Series E-1 Preferred Stock $ 0 ( 5 ) ( 5 ) ( 5 ) Common Stock 70,679 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
ROBINS HARLAN S
C/O ADAPTIVE BIOTECHNOLOGIES CORPORATION
1551 EASTLAKE AVE E STE 200
SEATTLE, WA98102
Chief Scientific Officer
Signatures
/s/ Harlan S Robins by Stacy Taylor, Attorney-in-Fact 06/26/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
( 2 )The option is fully vested and exercisable.
( 3 )The options vested with respect to 1/4 of such shares on November 1, 2018, with 1/48 of such shares vesting thereafter at the end of each full month of continuous service until fully vested.
( 4 )The options vest with respect to 1/4 of such shares on January 1, 2020, with 1/48 of such shares vesting thereafter at the end of each full month of continuous service until fully vested.
( 5 )The shares of preferred stock will convert immediately upon the closing of an initial public offering of the Issuer's common stock on a one-for-one basis and have no expiration date.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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