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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1. Name and Address of Reporting Person*
Sarma Purnanand D

(Last) (First) (Middle)
C/O IMMUNOME, INC.
665 STOCKTON DRIVE, SUITE 300

(Street)
EXTON PA 19341

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/01/2020
3. Issuer Name and Ticker or Trading Symbol
Immunome Inc. [ IMNM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President and CEO
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (right to buy) (1) 03/02/2030 Common Stock 328,635 0.54 D
Employee Stock Option (right to buy) (2) 08/03/2030 Common Stock 91,840 2.4 D
Employee Stock Option (right to buy) (3) 08/03/2030 Common Stock 51,205 2.4 D
Explanation of Responses:
1. One forty-eighth (1/48th) of the shares subject to the option vested or shall vest each month commencing June 30, 2019, subject to the Reporting Person continuing to provide service through each such date.
2. One forty-eighth (1/48th) of the shares subject to the option vested or shall vest each month commencing April 15, 2020, subject to the Reporting Person continuing to provide service through each such date.
3. The shares subject to the option shall vest on November 1, 2024, subject to the Reporting Person continuing to provide service through each such date.
Remarks:
Exhibit List - Exhibit 24 - Power of Attorney
/s/ Jason Minio, Attorney-in-Fact 10/01/2020
** 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.