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*
| 20374 SENECA MEADOWS PARKWAY |
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(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
11/27/2017
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3. Issuer Name and Ticker or Trading Symbol
INTREXON CORP
[ XON ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
| X |
Officer (give title below) |
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Other (specify below) |
| President, Precigen, Inc. |
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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 |
| Option to Purchase Common Stock (Right to Buy) |
|
07/17/2027 |
Common Stock |
150,000 |
22.83 |
D |
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| Explanation of Responses: |
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| Remarks: |
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/s/ Helen Sabzevari by Donald P. Lehr, as attorney-in-fact |
12/07/2017 |
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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. |
SECTION 16
POWER OF ATTORNEY
I, Helen Sabzevari, do hereby constitute and
appoint Donald P. Lehr and Rick L. Sterling,
my true and lawful attorneys-in-fact, either
of whom acting singly is hereby authorized,
for me and in my name and on my behalf as a
director, officer and/or shareholder of
INTREXON CORPORATION to (i) prepare, execute
in my name and on my behalf, and submit to the
U.S. Securities and Exchange Commission (the SEC)
a Form ID, including any necessary amendments thereto,
and any other documents necessary or appropriate to
obtain codes and passwords enabling me to make
electronic filings with the SEC of reports required
by Section 16(a) of the Securities Exchange Act of
1934 or any rule or regulation of the SEC in respect
thereof; and (ii) prepare, execute and file any and
all forms, instruments or documents, including any
necessary amendments thereto, as such attorneys or
attorney deems necessary or advisable to enable me
to comply with Section 16 of the Securities Exchange
Act of 1934 or any rule or regulation of the SEC in
respect thereof (collectively, Section 16).
I do hereby ratify and confirm all acts my said attorney
shall do or cause to be done by virtue hereof. I
acknowledge that the foregoing attorneys-in-fact,
serving in such capacity at my request, are not assuming,
nor is INTREXON CORPORATION assuming, any of my
responsibilities to comply with Section 16.
This power of attorney shall remain in full force and effect
until it is revoked by the undersigned in a signed writing
delivered to each such attorney-in-fact or the undersigned
is no longer required to comply with Section 16, whichever
occurs first.
WITNESS the execution hereof this 30th day of November, 2017.
/s/ Helen Sabzevari
Helen Sabzevari
