Statement of Changes in Beneficial Ownership (4)
June 01 2021 - 7:02PM
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
*
ROSA-BJORKESON DAGMAR |
2. Issuer Name and Ticker or Trading Symbol
INTERCEPT PHARMACEUTICALS, INC.
[
ICPT
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
|
|
(Last)
(First)
(Middle)
C/O INTERCEPT PHARMACEUTICALS, INC., 10 HUDSON YARDS, FLOOR 37 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
5/27/2021 |
|
(Street)
NEW YORK, NY 10001
(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 | 5/27/2021 | | A | | 10543 (1) | A | $0 | 10543 | D | |
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 |
| Option to Purchase Common Stock | $17.08 | 5/27/2021 | | A | | 17719 | | (2) | 5/27/2031 | Common Stock | 17719 | $0 | 17719 | D | |
| Explanation of Responses: |
| (1) | Represents restricted stock units granted to the Reporting Person. Each restricted stock unit represents a contingent right to receive one share of the Issuer's Common Stock. 1/3rd of the shares subject to the award shall vest on each anniversary of the Vesting Commencement Date (or, if earlier in any given year, the day immediately preceding the date of the Issuer's Annual Meeting of Stockholders in such year). The Vesting Commencement Date is April 1, 2021. |
| (2) | 1/3rd of the options subject to the award shall vest and become exercisable on each anniversary of the Vesting Commencement Date (or, if earlier in any given year, the day immediately preceding the date of the Issuer's Annual Meeting of Stockholders in such year). The Vesting Commencement Date is April 1, 2021. |
Reporting Owners
|
| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
ROSA-BJORKESON DAGMAR
C/O INTERCEPT PHARMACEUTICALS, INC.
10 HUDSON YARDS, FLOOR 37
NEW YORK, NY 10001 | X |
|
|
|
Signatures
|
| /s/ Mary J. Grendell, as attorney-in-fact | | 6/1/2021 |
| **Signature of Reporting Person | Date |
Intercept Pharmaceuticals (NASDAQ:ICPT)
Historical Stock Chart
From Jun 2024 to Jul 2024
Intercept Pharmaceuticals (NASDAQ:ICPT)
Historical Stock Chart
From Jul 2023 to Jul 2024
