# EDGAR Filing Document

**Accession Number:** 0001658551
**File Stem:** 0000899243-23-004990
**Filing Date:** 2023-2
**Character Count:** 6363
**Document Hash:** 83c0a20247adb17fad1507449effaf3c
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0000899243-23-004990.hdr.sgml**: 20230214

**ACCESSION NUMBER**: 0000899243-23-004990

**CONFORMED SUBMISSION TYPE**: 5

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20221231

**FILED AS OF DATE**: 20230214

**DATE AS OF CHANGE**: 20230214

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** MILNE GEORGE M JR
- **CENTRAL INDEX KEY:** 0001179552

**FILING VALUES:**
- **FORM TYPE:** 5
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41199
- **FILM NUMBER:** 23630403
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Amylyx Pharmaceuticals, Inc.
- **CENTRAL INDEX KEY:** 0001658551
- **STANDARD INDUSTRIAL CLASSIFICATION:** PHARMACEUTICAL PREPARATIONS [2834]
- **IRS NUMBER:** 464600503
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 43 THORNDIKE STREET
- **CITY:** CAMBRIDGE
- **STATE:** MA
- **ZIP:** 02141
- **BUSINESS PHONE:** 617-683-0917

**MAIL ADDRESS:**
- **STREET 1:** 43 THORNDIKE STREET
- **CITY:** CAMBRIDGE
- **STATE:** MA
- **ZIP:** 02141

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 5

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>MILNE GEORGE M JR<br><sub>(Last) (First) (Middle)</sub><br>C/O AMYLYX PHARMACEUTICALS, INC.<br>43 THORNDIKE STREET<br><sub>(Street)</sub><br>CAMBRIDGE, MA 02141<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2022-12-31 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Amylyx Pharmaceuticals, Inc. [ AMLX ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2022-01-06 |  | C |  | 689425 | A | <sup>(1)</sup> | 910821 | D |  |
| Common Stock | 2022-12-29 |  | G |  | 13800 | D | $0.00 | 897021 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Series A Preferred Stock | <sup>(1)</sup> | 2022-01-06 |  | C |  |  | 262282 | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 262282 | $0.00 | 0 | D |  |
| Series B Preferred Stock | <sup>(1)</sup> | 2022-01-06 |  | C |  |  | 384449 | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 384449 | $0.00 | 0 | D |  |
| Series C-1 Preferred Stock | <sup>(1)</sup> | 2022-01-06 |  | C |  |  | 19482 | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 19482 | $0.00 | 0 | D |  |
| Series C-2 Preferred Stock | <sup>(1)</sup> | 2022-01-06 |  | C |  |  | 23212 | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 23212 | $0.00 | 0 | D |  |

---

### Footnotes:

(1) Upon the closing of the Issuer's initial public offering, all shares of Series A, Series B, Series C-1 and Series C-2 Preferred Stock (the "Preferred Stock") automatically converted into the number of shares of the Issuer's Common Stock shown in column 4 of Table I without payment or further consideration. The Preferred Stock had no expiration date.

**Signature:** /s/ Joshua B. Cohen, as Attorney-in-Fact  
**Date:** 2023-02-14

### Remarks:

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.**