SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Societe des Produits Nestle S.A.

(Last) (First) (Middle)
AVENUE NESTLE 55

(Street)
CH-1800, VEVEY V8

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Axcella Health Inc. [ AXLA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
09/08/2020
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 09/08/2020 J(1) 4,305,541 A $4.42 4,305,541 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Societe des Produits Nestle S.A.

(Last) (First) (Middle)
AVENUE NESTLE 55

(Street)
CH-1800, VEVEY V8

(City) (State) (Zip)
1. Name and Address of Reporting Person*
NESTLE SA

(Last) (First) (Middle)
AVENUE NESTLE 55

(Street)
CH-1800, VEVEY V8

(City) (State) (Zip)
Explanation of Responses:
1. This transaction constitutes an internal transfer of 4,305,541 shares of Common Stock from Nestle Health Science US Holdings, Inc. ("NHS") to Societe des Products Nestle S.A. ("SPN"). The Common Stock was held by NHS. NHS is a wholly owned subsidiary of NIMCO US, Inc. ("NIMCO"). NIMCO, in turn, is a wholly-owned subsidiary of Nestle US Holdco, Inc. ("Nestle US Holdco"), which is a wholly-owned subsidiary of SPN. The ultimate parent company of NHS, NIMCO, Nestle US Holdco and SPN is Nestle S.A. ("Nestle"). Following the transfer, SPN and Nestle may be deemed to share voting and investment power with respect to all shares of Common Stock. Nestle disclaims beneficial ownership of such shares of Common Stock except to the extent of its pecuniary interest therein. Subsequent to this internal transfer, each of NHS, NIMCO, and Nestle US Holdco no longer hold any shares of Common Stock and are therefore no longer Reporting Owners.
Remarks:
/s/ NESTLE HEALTH SCIENCE US HOLDINGS, INC. By: Name: James Pepin, Title: Director and President 09/09/2020
/s/ NIMCO US, INC. By: Name: Dan Nugent, Title: Chief Legal Officer and General Counsel 09/09/2020
/s/ NESTLE US HOLDCO, INC. By: Name: Michael Prewitt, Title: Secretary 09/09/2020
/s/ NESTLE S.A. By: Name: Gregory Behar, Title: Deputy Executive Vice President 09/09/2020
** 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 4 (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.