Statement of Changes in Beneficial Ownership (4)
February 12 2020 - 4:59PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
Celona Lucia |
2. Issuer Name and Ticker or Trading Symbol
Apellis Pharmaceuticals, Inc.
[
APLS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) See Remarks |
(Last)
(First)
(Middle)
C/O APELLIS PHARMACEUTICALS, INC., 100 FIFTH AVENUE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/10/2020 |
(Street)
WALTHAM, MA 02451
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 2/10/2020 | | A | | 5213 (1) | A | $0.00 | 5213 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock option (right to buy) | $44.33 | 2/10/2020 | | A | | 31275 | | (2) | 2/9/2030 | Common Stock | 31275 | $0.00 | 31275 | D | |
Explanation of Responses: |
(1) | Consists of shares of Common Stock issuable under 5,213 restricted stock units ("RSUs") granted pursuant to the Company's 2017 Stock Incentive Plan. Each RSU represents the right to receive one share of Common Stock upon vesting. This RSU was granted on February 10, 2020 and will vest as to 25% of the shares underlying the RSU on the first anniversary of the grant, and 25% of the shares underlying the RSU on each anniversary of the grant thereafter through the fourth anniversary of the grant. |
(2) | This option was granted on February 10, 2020 and will vest as to 25% of the shares underlying the options on the first anniversary of the grant, with the remaining 75% of the shares underlying the option vesting in equal monthly installments thereafter through the fourth anniversary of the grant, subject to continued service. |
Remarks: Chief People Officer |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Celona Lucia C/O APELLIS PHARMACEUTICALS, INC. 100 FIFTH AVENUE WALTHAM, MA 02451 |
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| See Remarks |
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Signatures
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/s/ David Watson, attorney-in-fact for Lucia Celona | | 2/12/2020 |
**Signature of Reporting Person | Date |
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