SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
TVM V LIFE SCIENCE VENTURES GMBH & CO KG

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
MAXIMILIANSTRASSE 35C

(Street)
MUNICH 2M 80539

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
bluebird bio, Inc. [ BLUE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
06/24/2013
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 06/24/2013 C 2,254,357(1) A (1) 2,254,357 D(2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A-1 Convertible Preferred Stock (3) 06/24/2013 C 6,169,117 (3) (3) Common Stock 325,255 $0 0 D(2)
Series A-2 Convertible Preferred Stock (3) 06/24/2013 C 11,835,834 (3) (3) Common Stock 624,021 $0 0 D(2)
Series B Convertible Preferred Stock (3) 06/24/2013 C 17,749,014 (3) (3) Common Stock 935,783 $0 0 D(2)
Series C Convertible Preferred Stock (3) 06/24/2013 C 3,994,248 (3) (3) Common Stock 210,589 $0 0 D(2)
Series D Convertible Preferred Stock (3) 06/24/2013 C 3,010,234 (3) (3) Common Stock 158,709 $0 0 D(2)
Series A-1 Warrants $0.6619 06/24/2013 J(5) 660,982 (4) 11/16/2015 Series A-1 Convertible Preferred Stock 660,982 $0 0 D(2)
Common Stock Warrants $12.55 06/24/2013 J(5) 34,849 (4) 11/16/2015 Common Stock 34,849 $0 34,849 D(2)
Series A-1 Warrants $0.6619 06/24/2013 J(5) 440,650 (4) 10/26/2016 Series A-1 Convertible Preferred Stock 440,650 $0 0 D(2)
Common Stock Warrants $12.55 06/24/2013 J(5) 23,232 (4) 10/26/2016 Common Stock 23,232 $0 23,232 D(2)
Series A-1 Warrants $0.6619 06/24/2013 J(5) 1,038,674 (4) 05/03/2017 Series A-1 Convertible Preferred Stock 1,038,674 $0 0 D(2)
Common Stock Warrants $12.55 06/24/2013 J(5) 54,760 (4) 05/03/2017 Common Stock 54,760 $0 54,760 D(2)
Series A-1 Warrants $0.6619 06/24/2013 J(5) 236,062 (4) 08/28/2018 Series A-1 Convertible Preferred Stock 236,062 $0 0 D(2)
Common Stock Warrants $12.55 06/24/2013 J(5) 12,445 (4) 08/28/2018 Common Stock 12,445 $0 12,445 D(2)
Series A-1 Warrants $0.6619 06/24/2013 J(5) 236,062 (4) 12/18/2018 Series A-1 Convertible Preferred Stock 236,062 $0 0 D(2)
Common Stock Warrants $12.55 06/24/2013 J(5) 12,445 (4) 12/18/2018 Common Stock 12,445 $0 12,445 D(2)
Series A-1 Warrants $0.6619 06/24/2013 J(5) 462,681 (4) 04/15/2019 Series A-1 Convertible Preferred Stock 462,681 $0 0 D(2)
Common Stock Warrants $12.55 06/24/2013 J(5) 24,393 (4) 04/15/2019 Common Stock 24,393 $0 24,393 D(2)
Series B Warrants $0.3262 06/24/2013 J(6) 287,400 (4) 04/15/2019 Series B-1 Convertible Preferred Stock 287,400 $0 0 D(2)
Common Stock Warrants $6.19 06/24/2013 J(6) 15,152 (4) 04/15/2019 Common Stock 15,152 $0 15,152 D(2)
1. Name and Address of Reporting Person*
TVM V LIFE SCIENCE VENTURES GMBH & CO KG

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
MAXIMILIANSTRASSE 35C

(Street)
MUNICH 2M 80539

(City) (State) (Zip)
1. Name and Address of Reporting Person*
TVM Capital GmbH

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
MAXIMILIANSTRASSE 35C

(Street)
MUNICH 2M 80539

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Polack Axel

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
MAXIMILIANSTRASSE 35C

(Street)
MUNICH 2M 80539

(City) (State) (Zip)
1. Name and Address of Reporting Person*
SCHUHSLER HELMUT

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
MAXIMILIANSTRASSE 35C

(Street)
MUNICH 2M 80539

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Goll Alexandra

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
MAXIMILIANSTRASSE 35C

(Street)
MUNICH 2M 80539

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Birner Hubert

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
MAXIMILIANSTRASSE 35C

(Street)
MUNICH 2M 80539

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Fischer Stefan

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
MAXIMILIANSTRASSE 35C

(Street)
MUNICH 2M 80539

(City) (State) (Zip)
Explanation of Responses:
1. This transaction represents the total number of shares received upon conversion of bluebird bio, Inc. ("bluebird") Series A-1 Convertible Preferred Stock ("Series A-1 Shares"), Series A-2 Convertible Preferred Stock ("Series A-2 Shares"), Series B Convertible Preferred Stock ("Series B Shares"), Series C Convertible Preferred Stock ("Series C Shares") and Series D Convertible Preferred Stock (the "Series D Shares" and together with the Series A-1 Shares, Series A-2 Shares, Series B Shares and Series C Shares, collectively, the "Preferred Shares").
2. The shares are held directly by TVM V Life Science Ventures GmbH & Co. KG ("TVM V"). TVM V's general partner, TVM Capital GmbH ("TVM"), and its authorized officers, Axel Polack ("Polack"), Helmut Schuehsler ("Schuehsler"), Alexandra Goll ("Goll"), Hubert Birner ("Birner") and Stefan Fischer ("Fischer") may be deemed to share voting and dispositive power over the shares held by TVM V. Each of TVM, Polack, Schuehsler, Goll, Birner and Fischer disclaims beneficial ownership of these shares except to the extent of their pecuniary interest therein, if any.
3. The Preferred Shares automatically converted into bluebird Common Stock on an 18.967-for-one ratio upon the closing of the initial public offering of bluebird without payment of further consideration. The Preferred Shares had no expiration date.
4. The warrants are currently exercisable.
5. This transaction represents a deemed disposition of warrants to purchase shares of Series A-1 Convertible Preferred Stock and a deemed acquisition of warrants to purchase shares of Common Stock on an 18.967-for-one basis, which happened automatically upon the closing of the initial public offering of bluebird without payment of further consideration. The transaction is listed solely for the purpose of reporting the change in the shares underlying the warrants.
6. This transaction represents a deemed disposition of warrants to purchase shares of Series B Convertible Preferred Stock and a deemed acquisition of warrants to purchase shares of Common Stock on an 18.967-for-one basis, which happened automatically upon the closing of the initial public offering of bluebird without payment of further consideration. The transaction is listed solely for the purpose of reporting the change in the shares underlying the warrants.
/s/ Stefan Fischer, Attorney-in-Fact for TVM V Life Science Ventures GmbH & Co. KG 06/24/2013
/s/ Stefan Fischer, Attorney-in-Fact for TVM Capital GmbH 06/24/2013
/s/ Stefan Fischer, Attorney-in-Fact for Axel Polack 06/24/2013
/s/ Stefan Fischer, Attorney-in-Fact for Helmut Schuehsler 06/24/2013
/s/ Stefan Fischer, Attorney-in-Fact for Alexandra Goll 06/24/2013
/s/ Stefan Fischer, Attorney-in-Fact for Hubert Birner 06/24/2013
/s/ Stefan Fischer 06/24/2013
** Signature of Reporting Person Date
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