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*
TAS Partners, LLC

(Last) (First) (Middle)
36 WOODMAN ROAD

(Street)
CHESTNUT HILL MA 02467

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/21/2016
3. Issuer Name and Ticker or Trading Symbol
SELECTA BIOSCIENCES INC [ SELB ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X 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)
Common Stock 21,013 I See Footnote(1)(4)
Common Stock 19,702 I See Footnote(2)(4)
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 Convertible Preferred Stock (3) (3) Common Stock 157,864 (3) I See Footnote(1)(4)
Series B Convertible Preferred Stock (3) (3) Common Stock 157,864 (3) I See Footnote(2)(4)
Series C Convertible Preferred Stock (3) (3) Common Stock 153,742 (3) I See Footnote(1)(4)
Series C Convertible Preferred Stock (3) (3) Common Stock 93,954 (3) I See Footnote(2)(4)
Series D Convertible Preferred Stock (3) (3) Common Stock 63,547 (3) I See Footnote(1)(4)
Series D Convertible Preferred Stock (3) (3) Common Stock 51,355 (3) I See Footnote(2)(4)
Series E Convertible Preferred Stock (3) (3) Common Stock 84,421 (3) I See Footnote(1)(4)
Series E Convertible Preferred Stock (3) (3) Common Stock 79,156 (3) I See Footnote(2)(4)
Common Warrants 07/24/2015 07/24/2018 Common Stock 5,326 17.55 I See Footnote(1)(4)
Common Warrants 07/24/2015 07/24/2018 Common Stock 4,304 17.55 I See Footnote(2)(4)
1. Name and Address of Reporting Person*
TAS Partners, LLC

(Last) (First) (Middle)
36 WOODMAN ROAD

(Street)
CHESTNUT HILL MA 02467

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Leukon Investments, LP

(Last) (First) (Middle)
36 WOODMAN ROAD

(Street)
CHESTNUT HILL MA 02467

(City) (State) (Zip)
1. Name and Address of Reporting Person*
SPRINGER TIMOTHY A

(Last) (First) (Middle)
36 WOODMAN ROAD

(Street)
CHESTNUT HILL MA 02467

(City) (State) (Zip)
Explanation of Responses:
1. Held by Leukon Investments LP ("Leukon").
2. Held by TAS Partners, LLC ("TAS").
3. The preferred stock is convertible at any time, 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.
4. LKST, Inc. is the general partner of Leukon. Timothy Springer is the president of LKST, Inc. and the managing member of TAS. Each of the reporting persons disclaims beneficial ownership of the securities reported herein except to the extent of their pecuniary interest therein.
TAS Partners, LLC By: /s/ Timothy A. Springer, Ph.D., Manager 06/21/2016
Leukon Investments LP By: LKST, Inc., its general partner By: /s/ Timothy A. Springer, Ph.D., President 06/21/2016
/s/ Timothy A. Springer, Ph.D. 06/21/2016
** 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).
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