# EDGAR Filing Document

**Accession Number:** 0001745958
**File Stem:** 0000899243-23-000260
**Filing Date:** 2023-1
**Character Count:** 13242
**Document Hash:** 76cccd53f23e1c6653ae2c61b98f59c9
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0000899243-23-000260.hdr.sgml**: 20230103

**ACCESSION NUMBER**: 0000899243-23-000260

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20221229

**FILED AS OF DATE**: 20230103

**DATE AS OF CHANGE**: 20230103

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Jerel Davis
- **CENTRAL INDEX KEY:** 0001745958

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-39335
- **FILM NUMBER:** 23502719

**BUSINESS ADDRESS:**
- **STREET 1:** ONE SANSOME STREET, SUITE 3630
- **CITY:** SAN FRANCISCO
- **STATE:** CA
- **ZIP:** 94104
- **BUSINESS PHONE:** 415-801-8100

**MAIL ADDRESS:**
- **STREET 1:** ONE SANSOME STREET, SUITE 3630
- **CITY:** SAN FRANCISCO
- **STATE:** CA
- **ZIP:** 94104
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Repare Therapeutics Inc.
- **CENTRAL INDEX KEY:** 0001808158
- **STANDARD INDUSTRIAL CLASSIFICATION:** PHARMACEUTICAL PREPARATIONS [2834]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** Z4
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 7210 FREDERICK-BANTING, SUITE 100
- **CITY:** ST-LAURENT
- **STATE:** A8
- **ZIP:** H4S 2A1
- **BUSINESS PHONE:** (857) 412-7018

**MAIL ADDRESS:**
- **STREET 1:** 7210 FREDERICK-BANTING, SUITE 100
- **CITY:** ST-LAURENT
- **STATE:** A8
- **ZIP:** H4S 2A1

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

## FORM 4

### 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>Jerel Davis<br><sub>(Last) (First) (Middle)</sub><br>C/O REPARE THERAPEUTICS INC.<br>7210 FREDERICK-BANTING, SUITE 100<br><sub>(Street)</sub><br>ST-LAURENT, A8 <br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2022-12-29 | **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>Repare Therapeutics Inc. [ RPTX ] | **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 Shares | 2022-12-29 |  | J<sup>(1)</sup> |  | 287157 | D | $0.00 | 563403 | I | See Footnote<sup>(2)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(3)</sup> |  | 62026 | A | $0.00 | 62026 | I | See Footnote<sup>(4)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(5)</sup> |  | 8638 | D | $0.00 | 16949 | I | See Footnote<sup>(6)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(7)</sup> |  | 1866 | A | $0.00 | 63892 | I | See Footnote<sup>(4)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(8)</sup> |  | 9561 | D | $0.00 | 18761 | I | See Footnote<sup>(9)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(10)</sup> |  | 2065 | A | $0.00 | 65957 | I | See Footnote<sup>(4)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(11)</sup> |  | 65957 | D | $0.00 | 0 | I | See Footnote<sup>(4)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(12)</sup> |  | 1240 | A | $0.00 | 22117 | D |  |
| Common Shares | 2022-12-29 |  | J<sup>(13)</sup> |  | 21854 | D | $0.00 | 42877 | I | See Footnote<sup>(14)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(15)</sup> |  | 4721 | A | $0.00 | 4721 | I | See Footnote<sup>(16)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(17)</sup> |  | 4721 | D | $0.00 | 0 | I | See Footnote<sup>(16)</sup> |
| Common Shares | 2022-12-29 |  | J<sup>(18)</sup> |  | 3014 | A | $0.00 | 25131 | D |  |
| Common Shares |  |  |  |  |  |  |  | 2094451 | I | See Footnote<sup>(19)</sup> |
| Common Shares |  |  |  |  |  |  |  | 231211 | I | See Footnote<sup>(20)</sup> |

---

## 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 |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Venture Capital V, L.P. ("VVC V") to its partners.

(2) Shares held by VVC V. Versant Ventures V, LLC ("VV V") is the sole general partner of VVC V. The Reporting Person, a member of the Issuer's board of directors, is a managing director of VV V and may be deemed to share voting and dispositive power over the shares held by VVC V. Each of VV V and the Reporting Person disclaims beneficial ownership of the shares held by VVC V, except to the extent of their respective pecuniary interests therein.

(3) Represents a change in the form of ownership of VV V by virtue of the receipt of shares in the pro-rata in-kind distribution of common shares of the Issuer for no consideration by VVC V.

(4) Shares held by VV V. The Reporting Person, a member of the Issuer's board of directors, is a managing director of VV V and may be deemed to share voting and dispositive power over the shares held by VV V; however, the Reporting Person disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein.

(5) Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Affiliates Fund V, L.P. ("VAF V") to its partners.

(6) Shares held by VAF V. VV V is the sole general partner of VAF V. The Reporting Person, a member of the Issuer's board of directors, is a managing director of VV V and may be deemed to share voting and dispositive power over the shares held by VAF V. Each of VV V and the Reporting Person disclaims beneficial ownership of the shares held by VAF V, except to the extent of their respective pecuniary interests therein.

(7) Represents a change in the form of ownership of VV V by virtue of the receipt of shares in the pro-rata in-kind distribution of common shares of the Issuer for no consideration by VAF V.

(8) Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Ophthalmic Affiliates Fund I, L.P. ("VOAF I") to its partners.

(9) Shares held by VOAF I. VV V is the sole general partner of VOAF I. The Reporting Person, a member of the Issuer's board of directors, is a managing director of VV V and may be deemed to share voting and dispositive power over the shares held by VOAF I. Each of VV V and the Reporting Person disclaims beneficial ownership of the shares held by VOAF I, except to the extent of their respective pecuniary interests therein.

(10) Represents a change in the form of ownership of VV V by virtue of the receipt of shares in the pro-rata in-kind distribution of common shares of the Issuer for no consideration by VOAF I.

(11) Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by VV V, to its members.

(12) Represents a change in the form of ownership of the Reporting Person by virtue of the receipt of shares as a result of the pro-rata in-kind distribution of common shares of the Issuer for no consideration by VV V.

(13) Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Venture Capital V (Canada) LP ("VVC V (Canada)") to its partners.

(14) Shares held by VVC V (Canada). Versant Ventures V (Canada) GP-GP, Inc. ("VV V (Canada) GP") is the sole general partner of Versant Ventures V (Canada), L.P. ("VV V (Canada)") and VV V (Canada) is the sole general partner of VVC V (Canada). The Reporting Person, a member of the Issuer's board of directors, is a director of VV V (Canada) GP and may be deemed to share voting and dispositive power over the shares held by VVC V (Canada). Each of VV V (Canada), VV V (Canada) GP and the Reporting Person disclaims beneficial ownership of the shares held by VVC V (Canada), except to the extent of their respective pecuniary interests therein.

(15) Represents a change in the form of ownership of VV V (Canada) by virtue of the receipt of shares in the pro-rata in-kind distribution of common shares of the Issuer for no consideration by VVC V (Canada).

(16) Shares held by VV V (Canada). VV V (Canada) GP is the sole general partner of VV V (Canada). The Reporting Person, a member of the Issuer's board of directors, is a director of VV V (Canada) GP and may be deemed to share voting and dispositive power over the shares held by VV V (Canada). Each of VV V (Canada) GP and the Reporting Person disclaims beneficial ownership of the shares held by VV V (Canada), except to the extent of their respective pecuniary interests therein.

(17) Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by VV V (Canada), to its partners.

(18) Represents a change in the form of ownership of the Reporting Person by virtue of the receipt of shares as a result of the pro-rata in-kind distribution of common shares of the Issuer for no consideration by VV V (Canada).

(19) Shares held by Versant Venture Capital VI, L.P. ("VVC VI"). Versant Ventures VI GP-GP, LLC ("VV VI GP") is the sole general partner of Versant Ventures VI GP, L.P. ("VV VI") and VV VI is the sole general partner of VVC VI. The Reporting Person, a member of the Issuer's board of directors, is a managing director of VV VI GP and may be deemed to share voting and dispositive power over the shares held by VVC VI. Each of VV VI GP, VV VI and the Reporting Person disclaims beneficial ownership of the shares held by VVC VI, except to the extent of their respective pecuniary interests therein.

(20) Shares held by Versant Vantage I, L.P. ("VV I"). Versant Vantage I GP-GP, LLC ("VV I GP-GP") is the sole general partner of Versant Vantage I GP, L.P. ("VV I GP") and VV I GP is the sole general partner of VV I. The Reporting Person, a member of the Issuer's board of directors, is a managing director of VV I GP-GP and may be deemed to share voting and dispositive power over the shares held by VV I. Each of VV I GP-GP, VV I GP and the Reporting Person disclaims beneficial ownership of the shares held by VV I, except to the extent of their respective pecuniary interests therein.

**Signature:** /s/ Max Eisenberg, Attorney-in-Fact for Jerel C. Davis  
**Date:** 2023-01-03

### 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.**