SEC Filing | Adaptive Biotechnologies

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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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1. Name and Address of Reporting Person^*

BOBULSKY SUSAN

(Last)

(First)

(Middle)

C/O ADAPTIVE BIOTECHNOLOGIES CORPORATION

1165 EASTLAKE AVENUE EAST

(Street)

SEATTLE

98109

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
01/25/2024

3. Issuer Name and Ticker or Trading Symbol
Adaptive Biotechnologies Corp [ ADPT ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Chief Commercial Officer, MRD

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)
Common Stock	128,302	D

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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Stock Option (Right to Buy)	⁽¹⁾	10/13/2024	Common Stock	5,000	1.98	D
Stock Option (Right to Buy)	⁽¹⁾	04/25/2027	Common Stock	20,000	6.27	D
Stock Option (Right to Buy)	⁽¹⁾	04/24/2028	Common Stock	28,750	6.55	D
Stock Option (Right to Buy)	⁽²⁾	02/27/2030	Common Stock	13,474	28.32	D
Stock Option (Right to Buy)	⁽³⁾	08/13/2030	Common Stock	20,000	39.5	D
Stock Option (Right to Buy)	⁽⁴⁾	03/04/2031	Common Stock	22,894	43.68	D
Stock Option (Right to Buy)	⁽⁵⁾	03/04/2032	Common Stock	102,965	12.14	D
Stock Option (Right to Buy)	⁽⁶⁾	03/06/2033	Common Stock	88,689	8.46	D

Explanation of Responses:

1. The options are fully exercisable.

2. The options will vest with respect to 1/4 of such shares on February 27, 2021, with 1/48 of such shares vesting thereafter at the end of each full month of continuous service until fully vested.

3. The options will vest with respect to 1/4 of such shares on August 6, 2021, with 1/48 of such shares vesting thereafter at the end of each full month of continuous service until fully vested.

4. The options will vest with respect to 1/4 of such shares on March 4, 2022, with 1/48 of such shares vesting thereafter at the end of each full month of continuous service until fully vested.

5. The options will vest with respect to 1/4 of such shares on March 4, 2023, with 1/48 of such shares vesting thereafter at the end of each full month of continuous service until fully vested.

6. The options will vest with respect to 1/4 of such shares on March 4, 2024, with 1/48 of such shares vesting thereafter at the end of each full month of continuous service until fully vested.

	/s/ Susan Bobulsky by Stacy L. Taylor, Attorney-in-Fact	03/06/2024
	** 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.
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