SEC Form 4 · accession 0001209191-15-063393
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
Jul 31, 2015
Accepted (ET)
Aug 3, 2015 · 8:12 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001411906
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F1 | $2.68 | Jul 31, 2015 | A | 170,000 | A | — | Jul 31, 2025 | Common Stock | 170,000 | 170,000 | D |
Explanation of responses
- F1This is a performance based grant. The grant is issued in connection with an amendment to a certain employment agreement between the Reporting Person and the Issuer. The stock option vests and becomes exercisable upon the successful meeting of all endpoints in the Ampion clinical trial as determined by the Issuer's Compensation Committee of the Board of Directors.