SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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1. Name and Address of Reporting Person*
Crombez Eric

(Last) (First) (Middle)
C/O ULTRAGENYX PHARMACEUTICAL INC.
60 LEVERONI COURT

(Street)
NOVATO CA 94949

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/01/2023
3. Issuer Name and Ticker or Trading Symbol
Ultragenyx Pharmaceutical Inc. [ RARE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP and Chief Medical Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 25,854(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (2) 11/17/2027 Common Stock 7,500 48.11 D
Stock Option (Right to Buy) (3) 03/01/2029 Common Stock 8,000 67.55 D
Stock Option (Right to Buy) (4) 03/01/2030 Common Stock 13,000 56.08 D
Stock Option (Right to Buy) (5) 03/01/2031 Common Stock 4,310 142.47 D
Stock Option (Right to Buy) (6) 03/01/2032 Common Stock 6,335 67.37 D
Stock Option (Right to Buy) (7) 03/01/2033 Common Stock 9,845 45.65 D
Explanation of Responses:
1. Includes 12,601 Restricted Stock Units ("RSUs") awarded under the Company's 2014 Incentive Plan. The RSUs vest with respect to 1/4th of the underlying shares on each anniversary of the grant date, such that the RSUs are fully vested on the fourth anniversary of the grant date. Of the 12,601 RSUs, 1,115 RSUs were granted on March 1, 2020, 720 RSUs were granted on March 1, 2021, 1,000 RSUs were granted on April 16, 2021, 2,381 RSUs were granted on March 1, 2022 and 7,385 RSUs were granted on March 1, 2023.
2. 1/4th of the shares initially subject to the option vested on November 17, 2018; thereafter, 1/48th of the shares initially subject to the option vested monthly.
3. 1/4th of the shares initially subject to the option vested on March 1, 2020; thereafter, 1/48th of the shares initially subject to the option vested monthly.
4. 1/4th of the shares initially subject to the option vested on March 1, 2021 thereafter, 1/48th of the shares initially subject to the option shall vest monthly.
5. 1/4th of the shares initially subject to the option vested on March 1, 2022 thereafter, 1/48th of the shares initially subject to the option shall vest monthly.
6. 1/4th of the shares initially subject to the option vested on March 1, 2023 thereafter, 1/48th of the shares initially subject to the option shall vest monthly.
7. 1/4th of the shares initially subject to the option will vest on March 1, 2024 thereafter, 1/48th of the shares initially subject to the option shall vest monthly.
Remarks:
/s/ Karah Parschauer, attorney-in-fact 05/02/2023
** 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 5 (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.
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         LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS

  Know all by these presents, that the undersigned hereby makes, constitutes and
appoints each of Karah Parschauer, Wenchi Liu and Ryan Murr signing singly and
each acting individually, as the undersigned's true and lawful attorney-in-fact
with full power and authority as hereinafter described to:

       (1)  execute for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director and/or stockholder of Ultragenyx
Pharmaceutical Inc. (the "Company"), Forms 3, 4, and 5 (including any amendments
thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934
and the rules thereunder (the "Exchange Act");

       (2)  do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to prepare, complete and execute any such
Forms 3, 4, or 5, prepare, complete and execute any amendment or amendments
thereto, and deliver and file such form(s) with the United States Securities and
Exchange Commission (the "SEC") and any stock exchange or similar authority,
including without limitation the filing of a Form ID or any other application
materials to enable the undersigned to gain or maintain access to the Electronic
Data Gathering, Analysis and Retrieval system of the SEC;

       (3)  seek or obtain, as the undersigned's representative and on the
undersigned's behalf, information regarding transactions in the Company's
securities from any third party, including brokers, employee benefit plan
administrators and trustees, and the undersigned hereby authorizes any such
person to release any such information to such attorney-in-fact and approves and
ratifies any such release of information; and

       (4)  take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.

  The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this power of attorney and the rights and powers herein
granted.  The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming nor
relieving, nor is the Company assuming nor relieving, any of the undersigned's
responsibilities to comply with Section 16 of the Exchange Act.  The undersigned
acknowledges that neither the Company nor the foregoing attorneys-in-fact assume
(i) any liability for the undersigned's responsibility to comply with the
requirements of the Exchange Act, (ii) any liability of the undersigned for any
failure to comply with such requirements, or (iii) any obligation or liability
of the undersigned for profit disgorgement under Section 16(b) of the Exchange
Act.

  This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

  IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 27th day of April, 2023.

                                  /s/ Eric Crombez, M.D.
                                  Signature

                                 Eric Crombez, M.D.
                                  Print Name