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) 10/21/2021
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3. Issuer Name and Ticker or Trading Symbol
Xilio Therapeutics, Inc.
[ XLO ]
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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) |
X |
Other (specify below) |
See Remark 1 |
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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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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 |
Series B Preferred Stock |
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Common Stock |
218,705 |
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I |
Eight Roads Investments |
Explanation of Responses: |
Remarks: |
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Kevin M. Meagher, Duly authorized under Powers of Attorney, by and on behalf of Eight Roads Shareholdings Limited and its direct and indirect subsidiaries, Eight Roads Holdings Limited and Eight Roads Investments |
10/21/2021 |
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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. |
Exhibit 24
POWER OF ATTORNEY
Effective as of the date hereof, the undersigned does hereby appoint
Kevin M. Meagher, with full power of substitution, as the true and lawful
attorney of the undersigned, with full power and authority to execute such
documents and to make such regulatory or other filings and amendments
thereto as shall from time to time be required pursuant to the Securities
Exchange Act of 1934, as amended, any rules or regulations adopted
thereunder, and such other U.S. and non-U.S. laws, rules or regulations
as shall from time to time be applicable in respect of the beneficial
ownership of securities directly or indirectly attributable to the
undersigned, and generally to do all such things in the name and on behalf
of the undersigned in connection therewith as said attorney-in-fact deems
necessary or appropriate to cause such filings to be completed and filed.
This Power of Attorney shall remain in full force and effect only
for such time as Kevin M.Meagher shall continue to be an officer of
Fidelity Management & Research Company LLC,provided that, notwithstanding
the foregoing, this Power of Attorney may be revoked at any time by the
undersigned in writing.
This Power of Attorney has been executed as of the 11th day of
October, 2021.
Eight Roads Investments
By /s/ Driaan Viljoen
Driaan Viljoen
Director
POWER OF ATTORNEY
Effective as of the date hereof, the undersigned does hereby appoint
Kevin M. Meagher, with full power of substitution, as the true and lawful
attorney of the undersigned, with full power and authority to execute such
documents and to make such regulatory or other filings and amendments
thereto as shall from time to time be required pursuant to the Securities
Exchange Act of 1934, as amended, any rules or regulations adopted
thereunder, and such other U.S. and non-U.S. laws, rules or regulations
as shall from time to time be applicable in respect of the beneficial
ownership of securities directly or indirectly attributable to the
undersigned, and generally to do all such things in the name and on behalf
of the undersigned in connection therewith as said attorney-in-fact deems
necessary or appropriate to cause such filings to be completed and filed.
This Power of Attorney shall remain in full force and effect only
for such time as Kevin M.Meagher shall continue to be an officer of
Fidelity Management & Research Company LLC,provided that, notwithstanding
the foregoing, this Power of Attorney may be revoked at any time by the
undersigned in writing.
This Power of Attorney has been executed as of the 11th day of
October, 2021.
Eight Roads Holdings Limited
By /s/ Allan Pelvang
Allan Pelvang
Alternate Director
POWER OF ATTORNEY
Effective as of the date hereof, the undersigned does hereby appoint
Kevin M. Meagher, with full power of substitution, as the true and lawful
attorney of the undersigned, with full power and authority to execute such
documents and to make such regulatory or other filings and amendments
thereto as shall from time to time be required pursuant to the Securities
Exchange Act of 1934, as amended, any rules or regulations adopted
thereunder, and such other U.S. and non-U.S. laws, rules or regulations
as shall from time to time be applicable in respect of the beneficial
ownership of securities directly or indirectly attributable to the
undersigned, and generally to do all such things in the name and on behalf
of the undersigned in connection therewith as said attorney-in-fact deems
necessary or appropriate to cause such filings to be completed and filed.
This Power of Attorney shall remain in full force and effect only
for such time as Kevin M.Meagher shall continue to be an officer of
Fidelity Management & Research Company LLC,provided that, notwithstanding
the foregoing, this Power of Attorney may be revoked at any time by the
undersigned in writing.
This Power of Attorney has been executed as of the 11th day of
October, 2021.
Eight Roads Shareholdings Limited
By /s/ Allan Pelvang
Allan Pelvang
Director