SEC FORM
3
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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
C/O SAGE THERAPEUTICS, INC. |
215 FIRST STREET |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/15/2023
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3. Issuer Name and Ticker or Trading Symbol
Sage Therapeutics, Inc.
[ SAGE ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
Remarks: |
No securities are beneficially owned. |
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/s/ Jennifer Fitzpatrick, as Attorney-in-Fact for Jessica J. Federer |
03/17/2023 |
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** 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. |
POWER OF ATTORNEY
I, the undersigned, hereby authorize and designate Anne Marie
Cook (SVP, General Counsel), Kimi Iguchi (Chief Financial Officer)
and Jennifer Fitzpatrick (VP, Corporate Counsel), for as long as they
remain employees of Sage Therapeutics, Inc., and Stuart Falber of
WilmerHale, each acting singly, or their successors in role, to take
the following actions, acting as my agent and attorney-in-fact, with
full power of substitution:
(1) to prepare and sign on my behalf any Form 4 or Form 5
pursuant to Section 16 of the Securities Exchange Act of 1934, as
amended, and to file the same with the Securities and Exchange
Commission, Nasdaq, NYSE, and each stock exchange on which shares of
Common Stock or other securities of Sage Therapeutics, Inc. are
listed, as required by law;
(2) to prepare and sign on my behalf any Form 144 pursuant
to the Securities Act of 1933, as amended, and to file the same with
the Securities and Exchange Commission, Nasdaq, NYSE, and each stock
exchange on which shares of Common Stock or other securities of Sage
Therapeutics, Inc. are listed, as required by law; and
(3) take any other action necessary or proper in
connection with the foregoing.
Unless earlier revoked under the next sentence, this Power of
Attorney shall remain in effect as long as I am a director or
executive officer of Sage Therapeutics, Inc., and shall not be
affected by my subsequent disability or incompetence. I may revoke
this Power of Attorney by written notice delivered, in person or by
nationally recognized courier, to the attention of the SVP, General
Counsel of Sage Therapeutics, Inc.
Name: Jessica J. Federer
Date: 3/15/2023
P (617) 299-8380 . F (617) 299-8379 . 215 First Street, Cambridge, MA 02142