SEC Form 3 · accession 0001628280-18-001251
Evolus, Inc. · EOLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Rui Avelar
Officer — Chief Medical Officer
Period of report
Feb 7, 2018
Accepted (ET)
Feb 7, 2018 · 9:04 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001570562
Table I — non-derivative securities
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)F2,F3 | $9.98 | holding | — | — | — | — | Jan 6, 2028 | Common Stock | 199,702 | — | D |
Explanation of responses
- 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 January 6, 2018, provided the reporting person remains in continuous service before the vesting date, subject to accelerated vesting in certain events, including 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 upon certain changes of control of the Issuer.
Remarks
Exhibit List: Exhibit 24.1 - Power of Attorney