0001415889-20-000058.txt : 20200106
0001415889-20-000058.hdr.sgml : 20200106
20200106160848
ACCESSION NUMBER: 0001415889-20-000058
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200102
FILED AS OF DATE: 20200106
DATE AS OF CHANGE: 20200106
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Stevens David R
CENTRAL INDEX KEY: 0001292382
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35182
FILM NUMBER: 20509736
MAIL ADDRESS:
STREET 1: 300 ELLIOTT AVENUE WEST
STREET 2: SUITE 500
CITY: SEATTLE
STATE: WA
ZIP: 98119-4114
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ampio Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001411906
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 260179592
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 373 INVERNESS PARKWAY
STREET 2: SUITE 200
CITY: ENGLEWOOD
STATE: CO
ZIP: 80112
BUSINESS PHONE: 720-437-6500
MAIL ADDRESS:
STREET 1: 373 INVERNESS PARKWAY
STREET 2: SUITE 200
CITY: ENGLEWOOD
STATE: CO
ZIP: 80112
FORMER COMPANY:
FORMER CONFORMED NAME: Chay Enterprises, Inc.
DATE OF NAME CHANGE: 20070910
4
1
form4-01062020_010135.xml
X0306
4
2020-01-02
0001411906
Ampio Pharmaceuticals, Inc.
AMPE
0001292382
Stevens David R
C/O AMPIO PHARMACEUTICALS, INC.
373 INVERNESS PARKWAY, SUITE 200
ENGLEWOOD
CO
80112
true
false
false
false
Common Stock
2020-01-02
4
A
0
34059
0.5872
A
121049
D
The shares were issued to the Reporting Person under the Issuer's 2019 Stock Option and Incentive Plan and pursuant to compensation agreements approved by the Board of Directors of the Issuer.
/s/ David Stevens
2020-01-06