Sec Form 4 Filing - Borisy Alexis @ Revolution Medicines, Inc. - 2023-11-09

Insider filing report for Changes in Beneficial Ownership
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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
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
Borisy Alexis
2. Issuer Name and Ticker or Trading Symbol
Revolution Medicines, Inc. [ RVMD]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O REVOLUTION MEDICINES, INC., 700 SAGINAW DR
3. Date of Earliest Transaction (MM/DD/YY)
11/09/2023
(Street)
REDWOOD CITY, CA94063
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 11/09/2023 A 2,091,672 ( 1 ) A 2,331,494 ( 2 ) D
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
Earn-out Shares ( 3 ) 11/09/2023 A( 3 ) 296,039 ( 3 ) 12/17/2024 Common Stock 296,03 9 ( 3 ) 296,039 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Borisy Alexis
C/O REVOLUTION MEDICINES, INC.
700 SAGINAW DR
REDWOOD CITY, CA94063
X
Signatures
/s/ Jack Anders, as Attorney-in-fact for Alexis Borisy 11/14/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Pursuant to the Agreement and Plan of Merger (the "Merger Agreement"), dated as of July 31, 2023, at the effective time of the first merger contemplated by the Merger Agreement (the "Effective Time"), each share of common stock of EQRx, Inc. outstanding immediately prior to the Effective Time was converted into 0.1112 shares of common stock of Revolution Medicines, Inc. (the "Company"). The transaction was exempt from Section 16(b) of the Securities Exchange Act of 1934, as amended, pursuant to Rule 16b-3 promulgated thereunder.
( 2 )Includes 5,200 restricted stock units.
( 3 )Pursuant to the terms of the Agreement and Plan of Merger dated August 5, 2021, by and among the EQRx, Inc. (f/k/a CM Life Sciences III Inc.), Clover III Merger Sub Inc. and EQRx International, Inc. (f/k/a EQRx, Inc.), the reporting person was allocated the right to acquire an aggregate of 2,662,234 shares of common stock of EQRx, Inc. (the "Earn-out Shares"). At the Effective Time, each outstanding Earn-out Share was converted into a number of shares of the Company's common stock equal to the product of the number of Earn-out Shares and 0.1112, or in the case of the reporting person 296,039 Earn-out Shares. The transaction was exempt from Section 16(b) of the Securities Exchange Act of 1934, as amended, pursuant to Rule 16b-3 promulgated thereunder. The reporting person has signed a waiver and release waiving his interests in the Earn-out Shares.

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