# EDGAR Filing Document

**Accession Number:** 0001477123
**File Stem:** 0001209191-23-006062
**Filing Date:** 2023-2
**Character Count:** 6618
**Document Hash:** 17dbe56305acb1ac29889402a9f297de
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-006062.hdr.sgml**: 20230201

**ACCESSION NUMBER**: 0001209191-23-006062

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230130

**FILED AS OF DATE**: 20230201

**DATE AS OF CHANGE**: 20230201

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Segal Lloyd Mitchell
- **CENTRAL INDEX KEY:** 0001477123

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-39335
- **FILM NUMBER:** 23578633

**MAIL ADDRESS:**
- **STREET 1:** 2150 ST. ELZEAR BLVD. WEST
- **CITY:** LAVAL
- **STATE:** A8
- **ZIP:** H7L 4A8
**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>Segal Lloyd Mitchell<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 H4S 2A1<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-01-30 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_President and CEO_ |
| **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 | 2023-01-30 |  | A |  | 78550<sup>(1)</sup> | A | $0.00 | 84677<sup>(2)</sup> | D |  |
| Common Shares |  |  |  |  |  |  |  | 94466 | I | See footnote<sup>(3)</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 |
| Employee Stock Option (right to buy) | $12.42 | 2023-01-30 |  | A |  | 344200 |  | <sup>(4)</sup> | 2033-01-29 | Common Shares | 344200 | $0.00 | 344200 | D |  |

---

### Footnotes:

(1) Represents a restricted stock unit ("RSU") award. Thirty-three and one third percent (33 1/3%) of the RSUs shall vest on each of January 30, 2024, January 30, 2025 and January 30, 2026, subject to Reporting Person continuing to provide service through each such date.

(2) Includes 398 shares and 729 shares acquired on August 13, 2021 and February 15, 2022, respectively, under the Issuer's employee stock purchase plan.

(3) These securities are registered in the name of Arvala Inc. (f/k/a 3996953 Canada Inc., the "Company"). The Reporting Person is the sole stockholder of the Company.

(4) Twenty-five percent (25%) of the shares subject to the option shall vest on January 30, 2024, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter, subject to Reporting Person continuing to provide service through each such date.

**Signature:** /s/ Steve Forte, Attorney-in-Fact  
**Date:** 2023-02-01

### 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.**