SEC Form 3 · accession 0001628280-18-001249

Evolus, Inc. · EOLS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — See Remarks · Director

Period of report

Feb 7, 2018

Accepted (ET)

Feb 7, 2018 · 9:03 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001570562

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	holding	—	—		—	100,224	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Stock Option (Right to Buy)^F2,F3	$9.98	holding	—	—	—	—	Jan 6, 2028	Common Stock	688,625	—	D

F1Represents shares issuable on settlement of restricted stock units ("RSUs") granted to the reporting person. Each RSU represents a contingent right to receive one share of the Issuer's common stock. The RSUs will vest in full on the two year anniversary of the Issuer's initial public offering under the Securities Act of 1933, as amended, provided the reporting person remains in continuous service before the vesting date, subject to accelerated vesting in certain events, including certain terminations of the reporting person or upon certain changes of control of the Issuer.
F2Reflects a 1.6527-for-1 forward stock split of the Issuer's common stock effected on January 26, 2018.
F3The shares subject to the option will vest over a period of four years, with 1/4th of the shares subject to the option vesting annually on the anniversary of January 6, 2018, provided the reporting person remains in continuous service on each vesting date, subject to accelerated vesting in certain events, including certain terminations of the reporting person or upon certain changes of control of the Issuer.

President and Chief Executive Officer Exhibit List: Exhibit 24.1 - Power of Attorney