Statement of Changes in Beneficial Ownership (4)
June 10 2020 - 07:39PM
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
|
OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
|
Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
1. Name
and Address of Reporting Person * Liawatidewi Yakob |
2. Issuer Name and Ticker or Trading
Symbol Amphastar Pharmaceuticals, Inc. [ AMPH ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
EVP Corp Admin Center |
(Last)
(First)
(Middle)
C/O AMPHASTAR PHARMACEUTICALS, INC., 11570 6TH
STREET |
3. Date of Earliest Transaction (MM/DD/YYYY)
6/9/2020
|
(Street)
RANCHO CUCAMONGA, CA 91730
(City)
(State)
(Zip)
|
4. 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 |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
6/9/2020 |
|
M |
|
16000 |
A |
$10.93 |
69529 |
D |
|
Common Stock |
6/9/2020 |
|
S |
|
23405 |
D |
$20.406 (1) |
46124 |
D |
|
Common Stock |
|
|
|
|
|
|
|
2459 |
I |
See footnote (2) |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
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 |
Employee Stock Option (right to
buy) |
$10.93 |
6/9/2020 |
|
M |
|
|
16000 |
(3) |
7/30/2023 |
Common Stock |
16000 |
$0 |
16000 |
D |
|
Explanation of
Responses: |
(1) |
The price reported in Column
4 is a weighted average price. These shares were sold in multiple
transactions at prices ranging from $20.15 to $20.50 inclusive. The
reporting person undertakes to provide to the Issuer, any security
holder of the Issuer, or the staff of the Securities and Exchange
Commission, upon request, full information regarding the number of
shares sold at each separate price. |
(2) |
The reported shares are held
of record by the Yakob and Sunmoon Trust dated July 25, 2013 for
which the reporting person serves as a trustee. |
(3) |
Shares subject to the option
are fully vested and immediately exercisable. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Liawatidewi Yakob
C/O AMPHASTAR PHARMACEUTICALS, INC.
11570 6TH STREET
RANCHO CUCAMONGA, CA 91730 |
|
|
EVP Corp Admin Center |
|
Signatures
|
/s/ Eva Wen, by power of attorney |
|
6/10/2020 |
**Signature of Reporting
Person |
Date |