Statement of Changes in Beneficial Ownership (4)
August 23 2021 - 4:53PM
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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3235-0287
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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
*
Bejar Rafael |
2. Issuer Name and Ticker or Trading Symbol
Aptose Biosciences Inc.
[
APTO
]
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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) Sr. VP, Chief Medical Officer |
(Last)
(First)
(Middle)
C/O APTOSE BIOSCIENCES INC., 251 CONSUMERS ROAD, SUITE 1105 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
8/19/2021 |
(Street)
TORONTO, A6 M2J 4R3
(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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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 |
Performance Stock Option | $2.35 | 8/19/2021 | | A | | 200000 | | (1)(2) | 8/19/2031 | Common Shares | 200000 | $0 | 200000 | D | |
Performance Stock Option | $2.35 | 8/19/2021 | | A | | 200000 | | (1)(3) | 8/19/2031 | Common Shares | 200000 | $0 | 200000 | D | |
Explanation of Responses: |
(1) | The options were granted on August 19, 2021 and vest upon the earlier of (i) certain performance conditions or (ii) August 19, 2025, subject to Reporting Person's continued employment with the Issuer. |
(2) | Options vest in tranches connected with dose escalation trials. |
(3) | Options vest in connection with expansion trials. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Bejar Rafael C/O APTOSE BIOSCIENCES INC. 251 CONSUMERS ROAD, SUITE 1105 TORONTO, A6 M2J 4R3 |
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| Sr. VP, Chief Medical Officer |
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Signatures
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/s/ Janet Clennett as attorney-in-fact for Rafael Bejar | | 8/23/2021 |
**Signature of Reporting Person | Date |
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