SEC Form 5 · accession 0001181431-15-003105
Ampio Pharmaceuticals, Inc. · AMPE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Vaughan Lennox Clift
Officer — Chief Regulatory Affairs
Period of report
Dec 31, 2014
Accepted (ET)
Feb 23, 2015 · 6:32 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001411906
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 25, 2014 | J | 522,200 | $8.02 | D | 0 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On February 25, 2014, the wife of the reporting person contributed 522,200 shares of the issuer's common stock to a newly-formed limited liability company in exchange for all of the membership interests in the limited liability company. Neither the reporting person nor his wife is a manager of the limited liability company, neither the reporting person nor his wife may unilaterally dissolve or terminate the limited liability company, neither the reporting person nor his wife has or shares voting power or investment power with respect to the shares contributed to the limited liability company, and the reporting person has no voting power or investment power with respect to the membership interests in the limited liability company. Accordingly, the reporting person disclaims beneficial ownership of the shares of common stock contributed to the limited liability company.