0001415889-22-000089.txt : 20220103 0001415889-22-000089.hdr.sgml : 20220103 20220103201548 ACCESSION NUMBER: 0001415889-22-000089 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220101 FILED AS OF DATE: 20220103 DATE AS OF CHANGE: 20220103 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: 22503698 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 form4-01032022_050136.xml X0306 4 2022-01-01 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) 0.57 2022-01-01 4 A 0 250000 0 A 2032-01-01 Common Stock 250000 250000 D The stock option will vest on November 22, 2022. /s/ Daniel Stokely, Attorney-in-Fact 2022-01-03