Statement of Changes in Beneficial Ownership (4)
June 05 2020 - 5:29PM
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
*
SAMANT VIJAY B |
2. Issuer Name and Ticker or Trading Symbol
Brickell Biotech, Inc.
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BBI
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O BRICKELL BIOTECH, INC., 5777 CENTRAL AVENUE, SUITE 102 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/14/2020 |
(Street)
BOULDER, CO 80301
(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 | 2/14/2020 | | M | | 3070 | A | (1) | 3070 | D | |
Common Stock | 2/14/2020 | | F | | 1290 (2) | D | $1.16 | 1780 | D | |
Common Stock | 2/29/2020 | | M | | 608 | A | (1) | 2388 | D | |
Common Stock | 2/29/2020 | | F | | 256 (2) | D | $2.93 | 2132 | D | |
Common Stock | 3/31/2020 | | M | | 608 | A | (1) | 2740 | D | |
Common Stock | 3/31/2020 | | F | | 256 (2) | D | $1.19 | 2484 | D | |
Common Stock | 4/30/2020 | | M | | 609 | A | (1) | 3093 | D | |
Common Stock | 4/30/2020 | | F | | 256 (2) | D | $1.20 | 2837 | D | |
Common Stock | 5/31/2020 | | M | | 608 | A | (1) | 3445 | D | |
Common Stock | 5/31/2020 | | F | | 256 (2) | D | $1.16 | 3189 | D | |
Common Stock | 6/3/2020 | | A | | 15178 (3) | A | $0 | 18367 | 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 |
Restricted Stock Units | (1) | 2/14/2020 | | M | | 3070 | | (4) | (4) | Common Stock | 3070 | $0 | 3070 | D | |
Restricted Stock Units | (1) | 2/29/2020 | | M | | 608 | | (4) | (4) | Common Stock | 608 | $0 | 608 | D | |
Restricted Stock Units | (1) | 3/31/2020 | | M | | 608 | | (4) | (4) | Common Stock | 608 | $0 | 608 | D | |
Restricted Stock Units | (1) | 4/30/2020 | | M | | 609 | | (4) | (4) | Common Stock | 609 | $0 | 609 | D | |
Restricted Stock Units | (1) | 5/31/2020 | | M | | 608 | | (4) | (4) | Common Stock | 608 | $0 | 608 | D | |
Stock Option (right to buy) | $1.12 | 6/3/2020 | | A | | 4333 | | 8/31/2020 | 6/3/2030 | Common Stock | 4333 | $0 | 4333 | D | |
Explanation of Responses: |
(1) | Restricted stock units ("RSUs") converted into common stock on a one-for-one basis. |
(2) | Represents shares withheld to satisfy tax withholding obligations upon the vesting of RSUs. |
(3) | Represents RSUs that are scheduled to vest on August 31, 2020 and will be settled in the form of one share of common stock for each RSU. |
(4) | These RSUs were granted on February 14, 2020 and vest in installments through August 31, 2020. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
SAMANT VIJAY B C/O BRICKELL BIOTECH, INC. 5777 CENTRAL AVENUE, SUITE 102 BOULDER, CO 80301 | X |
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Signatures
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/s/ Christine G. Long, Attorney-in-Fact for Vijay B. Samant (power of attorney filed herewith) | | 6/5/2020 |
**Signature of Reporting Person | Date |
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