SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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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*
Patel Chintu

(Last) (First) (Middle)
C/O AMNEAL PHARMACEUTICALS, INC.
400 CROSSING BOULEVARD

(Street)
BRIDGEWATER NJ 08807

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Amneal Pharmaceuticals, Inc. [ AMRX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Co-CEO
3. Date of Earliest Transaction (Month/Day/Year)
03/04/2024
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Units (1) 03/04/2024 A 370,370 (2) (2) Class A Common Stock 370,370 $0 370,370 D
Performance-Based Restricted Stock Units (3) 03/04/2024 A 1,333,334 (4) (4) Class A Common Stock 1,333,334 $0 1,333,334 D
Explanation of Responses:
1. Each restricted stock unit represents a contingent right to receive one share of the Issuer's Class A Common Stock.
2. The restricted stock units vest in four equal annual installments beginning on March 4, 2025.
3. Each performance-based restricted stock unit represents a contingent right to receive one share of the Issuer's Class A Common Stock.
4. Represents a performance-based restricted stock unit grant 666,667 target shares. The performance-based restricted stock units are scheduled to vest based on the Issuer's Class A Common Stock achieving certain average closing price per share targets at the end of the three-year performance period. The number of shares that would be received upon vesting, if any, may vary from 0% to 200% of the target number. The number of performance-based restricted stock units reported in the table above represents the maximum number of shares issuable under the award. Any earned performance-based restricted stock units vest in full on February 28, 2027, the last day of the performance period.
Remarks:
Exhibit 24 attached - Power of Attorney
/s/ Denis Butkovic, Attorney-in-Fact 03/05/2024
** 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 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.
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POWER OF ATTORNEY Know all by these presents that the undersigned, does hereby make, constitute and appoint Denis Butkovic and Chris Daly as a true and lawful attorney-in-fact of the undersigned with full powers of substitution and revocation, for and in the name, place and stead of the undersigned (in the undersigned’s individual capacity), to execute and deliver such forms that the undersigned may be required to file with the U.S. Securities and Exchange Commission as a result of the undersigned’s ownership of or transactions in securities of Amneal Pharmaceuticals, Inc. pursuant to Sections 13(d), 13(g) and 16(a) of the Securities Exchange Act of 1934, as amended, including without limitation, Schedule 13D, Schedule 13G, Form 3, Form 4 and Form 5 (including any amendments thereto). The Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Schedule 13D, Schedule 13G, Forms 3, 4 and 5 with regard to his or her ownership of or transactions in securities of Amneal Pharmaceuticals, Inc., unless earlier revoked in writing. This Power of Attorney also serves to revoke and replace as of the date hereof, any prior Power of Attorney executed by the undersigned with respect to the ownership of securities of Amneal Pharmaceuticals, Inc. The undersigned acknowledges that Denis Butkovic and Chris Daly are not assuming any of the undersigned’s responsibilities to comply with Section 13 or Section 16 of the Securities Exchange Act of 1934, as amended. By:________________________ Name: Chintu Patel Date: ______________, 2023 DocuSign Envelope ID: B2998924-0695-4F64-A56D-22BF1D4316AD 5/5/2023 | 2:05 PM PDT


 

POWER OF ATTORNEY Know all by these presents that the undersigned, does hereby make, constitute and appoint Denis Butkovic and Chris Daly as a true and lawful attorney-in-fact of the undersigned with full powers of substitution and revocation, for and in the name, place and stead of the undersigned (in the undersigned’s individual capacity), to execute and deliver such forms that the undersigned may be required to file with the U.S. Securities and Exchange Commission as a result of the undersigned’s ownership of or transactions in securities of Amneal Pharmaceuticals, Inc. pursuant to Sections 13(d), 13(g) and 16(a) of the Securities Exchange Act of 1934, as amended, including without limitation, Schedule 13D, Schedule 13G, Form 3, Form 4 and Form 5 (including any amendments thereto). The Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Schedule 13D, Schedule 13G, Forms 3, 4 and 5 with regard to his or her ownership of or transactions in securities of Amneal Pharmaceuticals, Inc., unless earlier revoked in writing. This Power of Attorney also serves to revoke and replace as of the date hereof, any prior Power of Attorney executed by the undersigned with respect to the ownership of securities of Amneal Pharmaceuticals, Inc. The undersigned acknowledges that Denis Butkovic and Chris Daly are not assuming any of the undersigned’s responsibilities to comply with Section 13 or Section 16 of the Securities Exchange Act of 1934, as amended. By:________________________ Name: Chintu Patel Date: ______________, 2023 DocuSign Envelope ID: B2998924-0695-4F64-A56D-22BF1D4316AD 5/5/2023 | 2:05 PM PDT


 

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