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*
Sofinnova Venture Partners IX, L.P.

(Last) (First) (Middle)
C/O SOFINNOVA INVESTMENTS, INC.
3000 SAND HILL ROAD, BLDG. 4, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/06/2019
3. Issuer Name and Ticker or Trading Symbol
Galera Therapeutics, Inc. [ GRTX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. 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 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
Series B-2 Preferred Stock (2) (2) Common Stock 1,797,843 (2) D(1)
Series C Preferred Stock (2) (2) Common Stock 535,869 (2) D(1)
1. Name and Address of Reporting Person*
Sofinnova Venture Partners IX, L.P.

(Last) (First) (Middle)
C/O SOFINNOVA INVESTMENTS, INC.
3000 SAND HILL ROAD, BLDG. 4, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Sofinnova Management IX, L.L.C.

(Last) (First) (Middle)
C/O SOFINNOVA INVESTMENTS, INC.
3000 SAND HILL ROAD, BLDG. 4, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
POWELL MICHAEL

(Last) (First) (Middle)
C/O SOFINNOVA INVESTMENTS, INC.
3000 SAND HILL ROAD, BLDG. 4, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
HEALY JAMES

(Last) (First) (Middle)
C/O SOFINNOVA INVESTMENTS, INC.
3000 SAND HILL ROAD, BLDG. 4, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Mehra Anand

(Last) (First) (Middle)
C/O SOFINNOVA INVESTMENTS, INC.
3000 SAND HILL ROAD, BLDG. 4, SUITE 250

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
Explanation of Responses:
1. The shares reported herein are held of record by Sofinnova Venture Partners IX, L.P. ("SVP IX"). Dr. Michael F. Powell, Dr. James Healy and Dr. Anand Mehra are the managing members of Sofinnova Management IX, L.L.C., the general partner of SVP IX, and as such, may be deemed to share voting and investment power with respect to such shares. Each of the reporting persons disclaims beneficial ownership of such securities, except to the extent of such person's pecuniary interest therein.
2. Each share of the Issuer's preferred stock is convertible into shares of the Issuer's common stock on a 0.197763-for-one basis at the holder's election and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Nathalie Auber, attorney-in-fact for Sofinnova Venture Partners IX, L.P. 11/06/2019
/s/ Nathalie Auber, attorney-in-fact for Sofinnova Management IX, L.L.C. 11/06/2019
/s/ Nathalie Auber, attorney-in-fact for Michael F. Powell 11/06/2019
/s/ Nathalie Auber, attorney-in-fact for James Healy 11/06/2019
/s/ Nathalie Auber, attorney-in-fact for Anand Mehra 11/06/2019
** 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.
                                                                      Exhibit 24

                                 Power of Attorney

    Each of the undersigned entities and individuals (collectively, the
"Reporting Persons") hereby authorizes and designates Sofinnova Management IX,
L.L.C. or such other person or entity as is designated in writing by James I.
Healy (the "Designated Filer") as the beneficial owner to prepare and file on
behalf of such Reporting Person individually, or jointly together with the other
Reporting Persons, any and all reports, notices, communications and other
documents (including, but not limited to, reports on Schedule 13D, Schedule 13G,
Form 3, Form 4 and Form 5) that such Reporting Person may be required to file
with the United States Securities and Exchange Commission pursuant to the
Securities Act of 1933, as amended (together with the implementing regulations
thereto, the "Act") and the Securities Exchange Act of 1934, as amended
(together with the implementing regulations thereto, the "Exchange Act")
(collectively, the "Reports") with respect to each Reporting Person's ownership
of, or transactions in, securities of any entity whose securities are
beneficially owned (directly or indirectly) by such Reporting Person
(collectively, the "Companies").

    Each Reporting Person hereby further authorizes and designates Nathalie
Auber (the "Authorized Signatory") to execute and file on behalf of such
Reporting Person the Reports and to perform any and all other acts, which in the
opinion of the Designated Filer or Authorized Signatory may be necessary or
incidental to the performance of the foregoing powers herein granted.

    The authority of the Designated Filer and the Authorized Signatory under
this Document with respect to each Reporting Person shall continue until such
Reporting Person is no longer required to file any Reports with respect to the
Reporting Person's ownership of, or transactions in, the securities of the
Companies, unless earlier revoked in writing.  Each Reporting Person
acknowledges that the Designated Filer and the Authorized Signatory are not
assuming any of the Reporting Person's responsibilities to comply with the Act
or the Exchange Act.

Date: February 4, 2015

                         SOFINNOVA VENTURE PARTNERS IX, L.P.,
                         a Delaware Limited Partnership

                         By:   SOFINNOVA MANAGEMENT IX, L.L.C.,
                               a Delaware Limited Liability Company
                               Its General Partner

                         By:   /s/ James I. Healy
                               -------------------------------------------
                               James I. Healy
                               Managing Member

                         SOFINNOVA MANAGEMENT IX, L.L.C.,
                         a Delaware Limited Liability Company

                         By:   /s/ James I. Healy
                               -------------------------------------------
                               James I. Healy
                               Managing Member

                         By:   /s/ James I. Healy
                               -------------------------------------------
                               James I. Healy

                         By:   /s/ Srinivas Akkaraju
                               -------------------------------------------
                               Srinivas Akkaraju

                         By:   /s/ Michael F. Powell
                               -------------------------------------------
                               Michael F. Powell

                         By:   /s/ Anand Mehra
                               -------------------------------------------
                               Anand Mehra