Initial Statement of Beneficial Ownership (3)
November 16 2020 - 6:26PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Zaremba Rabourn Amy |
2. Date of Event Requiring Statement (MM/DD/YYYY)
11/11/2020
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3. Issuer Name and Ticker or Trading Symbol
Ocuphire Pharma, Inc. [OCUP]
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(Last)
(First)
(Middle)
C/O OCUPHIRE PHARMA, INC., 37000 GRAND RIVER AVE, SUITE 120 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) VP of Finance / |
(Street)
FARMINGTON HILLS, MI 48335
(City)
(State)
(Zip)
| 5. 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
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (right to buy) | (1) | 6/3/2030 | Common Stock | 21130 | $1.65 | D | |
Explanation of Responses: |
(1) | 2,113 shares vested on July 31, 2020, 2,113 shares vested on August 31, 2020, 1,056 shares vested on September 30, 2020, 1,056 shares vested on October 31, 2020 and the remaining shares vest in equal monthly installments at the end of each month from November 2020 through November 2021, with the balance vesting in December 2021, subject to continued service. |
Remarks: Exhibit 24, Power of Attorney, is attached. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Zaremba Rabourn Amy C/O OCUPHIRE PHARMA, INC. 37000 GRAND RIVER AVE, SUITE 120 FARMINGTON HILLS, MI 48335 |
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| VP of Finance |
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Signatures
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/s/ Emily J. Johns, by Power of Attorney | | 11/16/2020 |
**Signature of Reporting Person | Date |
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