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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 04/02/2024
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3. Issuer Name and Ticker or Trading Symbol
Roivant Sciences Ltd.
[ ROIV ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
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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Common Shares |
53,431,426 |
D |
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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 |
Stock Option (Right to Buy) |
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03/31/2026 |
Common Shares |
21,856,138 |
12.68 |
D |
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Stock Option (Right to Buy) |
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03/31/2026 |
Common Shares |
1,753,905 |
13.78 |
D |
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Stock Option (Right to Buy) |
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03/31/2026 |
Common Shares |
5,915,052 |
15.85 |
D |
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Capped Value Appreciation Rights |
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03/31/2026 |
Common Shares |
11,570,769 |
11.5 |
D |
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Explanation of Responses: |
Remarks: |
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By: /s/ Stephen Roberts, as Attorney-in-Fact for Vivek Ramaswamy |
04/12/2024 |
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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. |
GRANT OF LIMITED POWER OF ATTORNEY
I, Vivek Ramaswamy, of Columbus, Ohio, do hereby make, constitute,
and appoint Stephen Roberts, of Alexandria, Virginia, my true and
lawful attorney-in-fact for me and in my name, place, and stead,
and on my behalf, and for my use and benefit authorizing him:
1 To execute in my name any documents required for the receipt,
vesting, or purchase of shares of any equity instruments (to
include common shares, stock options, warrants, grants, and
capped value appreciation rights), and any documents required
for the reporting or acknowledgment of the same; and
2 To execute in my name any documents required to complete
sell-to-cover transactions associated with the transactions
described in Paragraph 1 of this Grant.
This Grant shall continue in effect until I revoke it by separate
written instrument.
/s/ Vivek Ramaswamy
Signature
8/21/2023
Date