Statement of Changes in Beneficial Ownership (4)
23 Décembre 2019 - 10:05PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
COELHO PHILIP H |
2. Issuer Name and Ticker or Trading Symbol
Ampio Pharmaceuticals, Inc.
[
AMPE
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
|
(Last)
(First)
(Middle)
C/O AMPIO PHARMACEUTICALS, INC., 373 INVERNESS PARKWAY, SUITE 200 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/19/2019 |
(Street)
ENGLEWOOD, CO 80112
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
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. Trans. Date
|
2A. Deemed Execution Date, if any
|
3. Trans. 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 Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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 |
Option (Right to Buy) | $.465 | 12/19/2019 | | A | | 36000 | | 1/14/2020 (1) | 12/19/2029 | Common Stock | 36000 | $0 | 36000 | D | |
Explanation of Responses: |
(1) | 3,000 of the options awarded vest and become exercisable on January 14, 2020. On the 14th of each month thereafter, 3,000 of the options awarded vest until fully vested. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
COELHO PHILIP H C/O AMPIO PHARMACEUTICALS, INC. 373 INVERNESS PARKWAY, SUITE 200 ENGLEWOOD, CO 80112 | X |
|
|
|
Signatures
|
/s/ Philip Coelho | | 12/20/2019 |
**Signature of Reporting Person | Date |
Ampio Pharmaceuticals (CE) (USOTC:AMPE)
Graphique Historique de l'Action
De Nov 2024 à Déc 2024
Ampio Pharmaceuticals (CE) (USOTC:AMPE)
Graphique Historique de l'Action
De Déc 2023 à Déc 2024
Real-Time news about Ampio Pharmaceuticals Inc (CE) (OTCMarkets): 0 recent articles
Plus d'articles sur Ampio Pharmaceuticals, Inc.