SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Lemieux Pierre

(Last) (First) (Middle)
C/O ACASTI PHARMA INC.
545 PROMENADE DU CENTROPOLIS, SUITE 100

(Street)
LAVAL A8 H7T 0A3

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/01/2020
3. Issuer Name and Ticker or Trading Symbol
Acasti Pharma Inc. [ ACST ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
COO & CSO
5. If Amendment, Date of Original Filed (Month/Day/Year)
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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Shares 7,000 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Share Option (Right to Buy) (1) 06/01/2022 Common Shares 16,900 $4.5(10) D
Share Option (Right to Buy) (2) 05/30/2023 Common Shares 31,400 $1.99(10) D
Share Option (Right to Buy) (3) 02/24/2027 Common Shares 50,000 $1.65(10) D
Share Option (Right to Buy) (4) 06/14/2027 Common Shares 93,000 $1.77(10) D
Share Option (Right to Buy) (5) 06/14/2027 Common Shares 62,000 $1.77(10) D
Share Option (Right to Buy) (6) 07/02/2028 Common Shares 365,515 $0.77(10) D
Share Option (Right to Buy) (7) 04/15/2029 Common Shares 79,300 $1.28(10) D
Share Option (Right to Buy) (8) 04/15/2029 Common Shares 270,700 $1.28(10) D
Share Option (Right to Buy) (9) 03/31/2030 Common Shares 587,000 $0.53(10) D
Explanation of Responses:
1. Represents 16,900 common shares underlying 16,900 share options granted on June 1, 2015. These share options vested in 12 equal installments on a quarterly basis starting from June 1, 2015 until June 1, 2018.
2. Represents 31,400 common shares underlying 31,400 share options granted on May 30, 2016. These share options vested in 12 equal installments on a quarterly basis starting from May 30, 2016 until May 30, 2019.
3. Represents 50,000 common shares underlying 50,000 share options granted on February 24, 2017. These share options vested in 12 equal installments on a quarterly basis starting from February 24, 2017 until February 24, 2020.
4. Represents 93,000 common shares underlying 93,000 share options granted on June 14, 2017. These share options vest in 12 equal installments on a quarterly basis starting from June 14, 2017 until June 14, 2020.
5. Represents 62,000 common shares underlying 62,000 share options granted on June 14, 2017. These share options vest in 12 equal installments on a quarterly basis starting from June 14, 2017 until June 14, 2020.
6. Represents 365,515 common shares underlying 365,515 share options granted on July 2, 2018. These share options vest in 12 equal installments on a quarterly basis starting from July 2, 2018 until July 2, 2021.
7. Represents 79,300 common shares underlying 79,300 share options granted on April 15, 2019. These share options vest in 12 equal installments on a quarterly basis starting from April 15, 2019 until April 15, 2022.
8. Represents 270,700 common shares underlying 270,700 share options granted on April 15, 2019. These share options vest in 12 equal installments on a quarterly basis starting from April 15, 2019 until April 15, 2022.
9. Represents 587,000 common shares underlying 587,000 share options granted on March 31, 2020. These share options vest in 12 equal installments on a quarterly basis starting from March 31, 2020 until March 31, 2023.
10. Canadian dollars.
Remarks:
Exhibit List - Exhibit 24 - Power of Attorney
/s/ Kelsey Weiner, Attorney-in-Fact 04/01/2020
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.