Sec Form 3 Filing - BLATT GREGORY R @ Vaxxinity, Inc. - 2021-11-10

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
BLATT GREGORY R
2. Issuer Name and Ticker or Trading Symbol
Vaxxinity, Inc. [ VAXX]
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 VAXXINITY, INC, 1717 MAIN ST, STE 3388
3. Date of Earliest Transaction (MM/DD/YY)
11/10/2021
(Street)
DALLAS, TX75201
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
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) $ 10.0673 ( 1 ) ( 1 ) Class A common stock 449,871 D
Series A preferred stock ( 2 ) ( 2 ) ( 2 ) Class A common stock ( 2 ) I See Note( 3 )
Series A preferred stock ( 4 ) ( 4 ) ( 4 ) Class A common stock ( 4 ) I See Note( 5 )
Series B preferred stock ( 6 ) ( 6 ) ( 6 ) Class A common stock ( 6 ) I See Note( 7 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
BLATT GREGORY R
C/O VAXXINITY, INC
1717 MAIN ST, STE 3388
DALLAS, TX75201
X
Signatures
/s/ Rene Paula, attorney-in-fact for Gregory R. Blatt 11/10/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents 449,871 time-vesting options. These options are subject to a two-year vesting schedule, beginning on 7/28/2021, vesting in equal installments each month during the vesting period.
( 2 )The 968,636 shares of Series A preferred stock will convert into 622,516 shares of Class A common stock automatically upon closing of the initial public offering based on a conversion rate of approximately 0.643 shares of Class A common stock for each share of Series A preferred stock.
( 3 )These shares are held by Blatt Family Investments LLC ("BFI"). The Reporting Person is the investment manager and a member of BFI, as well as the investment advisor of The Gregory R. Blatt 2018 GST Trust, which is also a member of BFI. The Reporting Person disclaims beneficial ownership, within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the securities held by BFI in which the Reporting Person has no pecuniary interest.
( 4 )The 83,329 shares of Series A preferred stock will convert into 53,553 shares of Class A common automatically upon closing of the initial public offering based on a conversion rate of approximately 0.643 shares of Class A common stock for each share of Series A preferred stock.
( 5 )These shares are held by The Gregory R. Blatt 2020 Annuity Trust IX. The Reporting Person is the sole trustee and the investment advisor with all investment authority.
( 6 )The 250,000 shares of Series B preferred stock will convert into 160,668 shares of Class A common stock automatically upon closing of the initial public offering based on a conversion rate of approximately 0.643 shares of Class A common stock for each share of Series B preferred stock.
( 7 )These shares are held by The Gregory R. Blatt 2020 Annuity Trust III. The Reporting Person is the sole trustee and the investment advisor with all investment authority.

Remarks:
Exhibit 24 - Power of Attorney

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