0001209191-22-005706.txt : 20220131
0001209191-22-005706.hdr.sgml : 20220131
20220131174035
ACCESSION NUMBER: 0001209191-22-005706
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220128
FILED AS OF DATE: 20220131
DATE AS OF CHANGE: 20220131
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mahmood Tahir Ph.D.
CENTRAL INDEX KEY: 0001813286
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39306
FILM NUMBER: 22575449
MAIL ADDRESS:
STREET 1: 1 TOWER PLACE, SUITE 850
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Applied Molecular Transport Inc.
CENTRAL INDEX KEY: 0001801777
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 814481426
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 450 EAST JAMIE COURT
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
BUSINESS PHONE: 650-392-0420
MAIL ADDRESS:
STREET 1: 450 EAST JAMIE COURT
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
FORMER COMPANY:
FORMER CONFORMED NAME: Applied Molecular Transport LLC
DATE OF NAME CHANGE: 20200130
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2022-01-28
0
0001801777
Applied Molecular Transport Inc.
AMTI
0001813286
Mahmood Tahir Ph.D.
C/O APPLIED MOLECULAR TRANSPORT INC.
450 EAST JAMIE COURT
SOUTH SAN FRANCISCO
CA
94080
1
1
0
0
Chief Executive Officer
Common Stock
2022-01-28
4
P
0
3000
7.88
A
3000
D
Common Stock
176657
I
By Irrevocable Trust
Common Stock
334632
I
By GRAT
Common Stock
3088711
I
By Living Trust
These shares are held directly by The Mahmood 2017 Irrevocable Trust for which the Reporting Person serves as trustee and over which shares the Reporting Person hold voting and dispositive power.
These shares are held directly by the Tahir Mahmood 2019 Annuity Trust for which the Reporting Person serves as trustee and over which shares the Reporting Person holds voting and dispositive power.
Includes 10,368 shares transferred from the Tahir Mahmood 2019 Annuity Trust since the last filing by the Reporting Person.
These shares are held directly by the Mahmood-Shamsi Living Trust Agreement for which the Reporting Person and spouse serve as co-trustees and over which shares the Reporting Person and his spouse hold voting and dispositive power.
/s/ Brandon Hants Attorney-in-Fact for Tahir Mahmood
2022-01-31