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*
Chrzanowski Holly D.

(Last) (First) (Middle)
C/O ATYR PHARMA, INC.
3545 JOHN HOPKINS COURT, SUITE #250

(Street)
SAN DIEGO CA 92121

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/06/2015
3. Issuer Name and Ticker or Trading Symbol
aTYR PHARMA INC [ LIFE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
See Remarks
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 1,885 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)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) (1) 12/14/2020 Common Stock 5,028 0.72 D
Stock Option (right to buy) (2) 06/02/2021 Common Stock 1,508 0.72 D
Stock Option (right to buy) (3) 09/13/2022 Common Stock 14,715 0.88 D
Stock Option (right to buy) (4) 06/28/2023 Common Stock 20,403 4.06 D
Stock Option (right to buy) (5) 03/05/2024 Common Stock 4,400 4.06 D
Stock Option (right to buy) (6) 04/17/2025 Common Stock 8,800 9.15 D
Explanation of Responses:
1. The shares subject to this option shall vest and become exercisable in 48 equal monthly installments beginning on December 14, 2010. This option is subject to accelerated vesting upon termination without cause upon a change of control of the Issuer.
2. The shares subject to this option shall vest and become exercisable in 48 equal monthly installments beginning on January 1, 2011. This option is subject to accelerated vesting upon termination without cause upon a change of control of the Issuer.
3. The shares subject to this option shall vest and become exercisable in 72 equal monthly installments beginning on September 13, 2012. This option is subject to accelerated vesting upon termination without cause upon a change of control of the Issuer.
4. The shares subject to this option shall vest and become exercisable in 72 equal monthly installments beginning on April 29, 2013. This option is subject to accelerated vesting upon termination without cause upon a change of control of the Issuer.
5. The shares subject to this option shall vest and become exercisable in 72 equal monthly installments beginning on January 1, 2014. This option is subject to accelerated vesting upon termination without cause upon a change of control of the Issuer.
6. The shares subject to this option shall vest and become exercisable in 48 equal monthly installments beginning on April 17, 2015. This option is subject to accelerated vesting upon termination without cause upon a change of control of the Issuer.
Remarks:
Vice President, Enterprise Talent and Organization Exhibit List Exhibit 24.1 - Power of Attorney
/s/ Nancy Krueger, as Attorney-in-Fact 05/06/2015
** 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.
                         LIMITED POWER OF ATTORNEY

        The undersigned hereby constitutes and appoints each of John Blake and
Nancy Krueger, signing singly, and with full power of substitution, the
undersigned's true and lawful attorney-in-fact to:

        (1)     execute for and on behalf of the undersigned, in the
undersigned's capacity as an officer and/or director of aTyr Pharma, Inc. (the
"Company"), from time to time the following U.S. Securities and Exchange
Commission ("SEC") forms: (i) Form ID, including any attached documents, to
effect the assignment of codes to the undersigned to be used in the transmission
of information to the SEC using the EDGAR System; (ii) Form 3, Initial Statement
of Beneficial Ownership of Securities, including any attached documents; (iii)
Form 4, Statement of Changes in Beneficial Ownership of Securities, including
any attached documents; (iv) Form 5, Annual Statement of Beneficial Ownership of
Securities in accordance with Section 16(a) of the Securities Exchange Act of
1934, as amended, and the rules thereunder, including any attached documents;
(v) Schedule 13D and (vi) amendments of each thereof, in accordance with the
Securities Exchange Act of 1934, as amended, and the rules thereunder, including
any attached documents;

        (2)     do and perform any and all acts for and on behalf of the
undersigned which may be necessary or desirable to complete and execute any such
Form 3, 4 or 5, Schedule 13D or any amendment(s) thereto, and timely file such
form(s) with the SEC and any securities exchange, national association or
similar authority; and

        (3)     take any other action of any type whatsoever in connection with
the foregoing which, in the opinion of such attorney-in-fact, may be of benefit
to, in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.

        The undersigned hereby grants to each such attorney-in-fact, acting
singly, full power and authority to do and perform any and every act and thing
whatsoever requisite, necessary or proper to be done in the exercise of any of
the rights and powers herein granted, as fully to all intents and purposes as
the undersigned might or could do if personally present, with full power of
substitution or revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall
lawfully do or cause to be done by virtue of this power of attorney and the
rights and powers herein granted. The undersigned acknowledges that the
foregoing attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming, nor is the Company assuming, any of the
undersigned's responsibilities to comply with Section 16 or Regulation 13D-G of
the Securities Exchange Act of 1934, as amended. The undersigned hereby agrees
to indemnify the attorney-in-fact and the Company from and against any demand,
damage, loss, cost or expense arising from any false or misleading information
provided by the undersigned to the attorney-in-fact.

        This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file such forms with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact. This Power of Attorney supersedes any prior power
of attorney in connection with the undersigned's capacity as an officer and/or
director of the Company. This Power of Attorney shall expire as to any
individual attorney-in-fact if such attorney-in-fact ceases to be an executive
officer of the Company.

        IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be executed as of May 6, 2015.

                                        /s/ Holly D. Chrzanowski
                                        ---------------------------------------
                                        Holly D. Chrzanowski