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Filing Details

Accession Number:: 0000899243-20-020554
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2020-07-28 16:45:58
Reporting Period:: 2020-07-28

Accepted Time:: 2020-07-28 16:45:58
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1528115	Annexon Inc.	ANNX	Pharmaceutical Preparations (2834)	275414423

Insiders

Cik	Name	Reported Address	Director	Officer	Large Shareholder	Other
1578965	Adam Koppel	C/O Bain Capital Life Sciences Investors Llc, 200 Clarendon Street Boston MA 02116	No	No	Yes	No
1687968	Bain Capital Life Sciences Fund, L.p.	200 Clarendon Street Boston MA 02116	No	No	Yes	No
1702921	Bcip Life Sciences Associates, Lp	200 Clarendon Street Boston MA 02116	No	No	Yes	No
1702957	Lawrence Jeffrey Schwartz	C/O Bain Capital Life Sciences Investors Llc, 200 Clarendon Street Boston MA 02116	No	No	Yes	No
1703030	Bain Capital Life Sciences Partners, Lp	200 Clarendon Street Boston MA 02116	No	No	Yes	No
1703031	Bain Capital Life Sciences Investors, Llc	200 Clarendon Street Boston MA 02116	No	No	Yes	No

Reported Non-Derivative Transactions

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Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2020-07-28	2,522,385	$0.00	2,522,385	No	4	C	Indirect	See Footnotes
Common Stock	Acquisiton	2020-07-28	319,243	$0.00	2,841,628	No	4	C	Indirect	See Footnotes
Common Stock	Acquisiton	2020-07-28	400,000	$17.00	3,241,628	No	4	P	Indirect	See Footnotes

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	See Footnotes
No	4	C	Indirect	See Footnotes
No	4	P	Indirect	See Footnotes

Reported Derivative Transactions

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series C Preferred Stock	Disposition	2020-07-28	22,222,221	$0.00	2,522,385	$0.00
Common Stock	Series D Preferred Stock	Disposition	2020-07-28	2,812,543	$0.00	319,243	$0.00

Remaning Holdings	Exercise Date	Expiration Date	Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
0			No	4	C	Indirect
0			No	4	C	Indirect

Footnotes

Each share of Series C Preferred Stock ("Series C Stock") and Series D Preferred Stock ("Series D Stock") automatically converted on a 1-for-8.81 basis into the Issuer's Common Stock immediately prior to the closing of the Issuer's initial public offering.
Represents 20,158,775 shares of Series C Stock held of record by Bain Capital Life Sciences Fund, L.P. ("BCLS") and 2,063,446 shares of Series C Stock held of record by BCIP Life Sciences Associates, LP ("BCIPLS" and, together with BCLS, the "Bain Capital Life Sciences Entities").
Represents 2,551,384 shares of Series D Stock held of record by BCLS and 261,159 shares of Series D Stock held of record by BCIPLS.
Represents 362,858 and 37,142 shares of the Issuer's Common Stock purchased by BCLS and BCIPLS, respectively, in the Issuer's initial public offering.
Bain Capital Life Sciences Partners, LP ("BCLSP") is the general partner of BCLS. As a result, BCLSP may be deemed to share voting and dispositive power with respect to the securities held by BCLS. BCLSP disclaims beneficial ownership of such securities except to the extent of its pecuniary interest therein.
Bain Capital Life Sciences Investors, LLC ("BCLSI"), whose managers are Jeffrey Schwartz and Adam Koppel, is the general partner of BCLSP and governs the investment strategy and decision-making process with respect to investments held by BCIPLS, whose general partner is Boylston Coinvestors, LLC. As a result, each of BCLSI, Mr. Schwartz and Dr. Koppel may be deemed to share voting and dispositive power over the shares held by the Bain Capital Life Sciences Entities. BCLSI, Mr. Schwartz and Dr. Koppel each disclaim beneficial ownership of such securities except to the extent of their pecuniary interest therein.