# EDGAR Filing Document

**Accession Number:** 0001693134
**File Stem:** 0001933414-23-000020
**Filing Date:** 2023-3
**Character Count:** 5850
**Document Hash:** b4b354751af6e5684be0eab47d5286e5
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001933414-23-000020.hdr.sgml**: 20230321

**ACCESSION NUMBER**: 0001933414-23-000020

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230317

**FILED AS OF DATE**: 20230321

**DATE AS OF CHANGE**: 20230321

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Levy Adam Scott
- **CENTRAL INDEX KEY:** 0001693134

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41614
- **FILM NUMBER:** 23750852

**MAIL ADDRESS:**
- **STREET 1:** C/O MIRAGEN THERAPEUTICS, INC.
- **STREET 2:** 6200 LOOKOUT ROAD, #100
- **CITY:** BOULDER
- **STATE:** CO
- **ZIP:** 80301
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Mineralys Therapeutics, Inc.
- **CENTRAL INDEX KEY:** 0001933414
- **STANDARD INDUSTRIAL CLASSIFICATION:** PHARMACEUTICAL PREPARATIONS [2834]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 150 N. RADNOR CHESTER ROAD
- **STREET 2:** SUITE F200
- **CITY:** RADNOR
- **STATE:** PA
- **ZIP:** 19087
- **BUSINESS PHONE:** (888) 378-6240

**MAIL ADDRESS:**
- **STREET 1:** 150 N. RADNOR CHESTER ROAD
- **STREET 2:** SUITE F200
- **CITY:** RADNOR
- **STATE:** PA
- **ZIP:** 19087

### 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>Levy Adam Scott<br><sub>(Last) (First) (Middle)</sub><br>150 N. RADNOR CHESTER ROAD,<br>SUITE F200<br><sub>(Street)</sub><br>RADNOR, PA 19087<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_CFO and Secretary_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Mineralys Therapeutics, Inc. [ MLYS ] | **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 |
|  |  |  |  |  |  |  |  |  |  |  |

---

## 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 |
| Stock Option | $15.44 | 2023-03-17 |  | A |  | 20000 |  | <sup>(1)</sup> | 2033-03-17 | Common Stock | 20000.0 | $0 | 20000 | D |  |

---

### Footnotes:

(1) The stock option vests as to 25% of the total number of shares of Common Stock subject to the option on the first anniversary of the grant date, and as to 1/48th of  the total number of shares of Common Stock subject to the option on each monthly anniversary thereafter.

**Signature:** /s/ Adam Levy  
**Date:** 2023-03-21

### 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.**