0001415889-21-005524.txt : 20211124
0001415889-21-005524.hdr.sgml : 20211124
20211124165059
ACCESSION NUMBER: 0001415889-21-005524
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211122
FILED AS OF DATE: 20211124
DATE AS OF CHANGE: 20211124
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MARTINO MICHAEL A
CENTRAL INDEX KEY: 0001238250
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35182
FILM NUMBER: 211447532
MAIL ADDRESS:
STREET 1: C/O AMBIT BIOSCIENCES CORPORATION
STREET 2: 11080 ROSELLE STREET
CITY: SAN DIEGO
STATE: CA
ZIP: 92121
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
form4-11242021_011146.xml
X0306
4
2021-11-22
0001411906
Ampio Pharmaceuticals, Inc.
AMPE
0001238250
MARTINO MICHAEL A
C/O AMPIO PHARMACEUTICALS, INC.
373 INVERNESS PARKWAY, SUITE 200
ENGLEWOOD
CO
80112
true
true
false
false
INTERIM CHAIRMAN AND CEO
Stock Option (Right to Buy)
1.14
2021-11-22
4
A
0
750000
0
A
2031-11-22
Common Stock
750000
750000
D
The stock option vested and became exercisable with respect to 500,000 shares of common stock on November 22, 2021, and will vest with respect to the remaining 250,000 shares of common stock on November 22, 2022.
/s/ Dan Stokely, Attorney-in-Fact
2021-11-24