SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
GRIFFIN BRIAN T

(Last) (First) (Middle)
4100 S. SAGINAW STREET

(Street)
FLINT MI 48507

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Diplomat Pharmacy, Inc. [ DPLO ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chairman and CEO
3. Date of Earliest Transaction (Month/Day/Year)
02/04/2020
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/04/2020 A 583,580(1) A $0 815,308 I BY grantor retained annuity trust(2)
Common Stock 02/04/2020 A 613,372(3) A $0 1,428,680 I By grantor retained annuity trust(2)
Common Stock 11,238(4) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. On June 4, 2018, reporting person was granted restricted stock units that were subject to the Issuer's satisfaction of certain financial performance criteria. On February 4, 2020 (the "determination date"), the performance criteria was met with respect to 583,580 restricted stock units all of which vested upon the determination date.
2. These shares are held by the Brian T. Griffin 2019 Grantor Retained Annuity Trust No. II.
3. On June 4, 2019, reporting person was granted restricted stock units that were subject to the Issuer's satisfaction of certain financial performance criteria. On February 4, 2020 (the "determination date"), the performance criteria was met with respect to 613,372 restricted stock units. One-third of the restricted stock units vested upon the determination date, and the remaining two-thirds will vest in two equal installments on each anniversary of the determination date, subject to continued employment.
4. Represents shares received upon the vesting of a portion of an inducement award of stock granted to the reporting person in connection with his appointment as CEO and Chairman, granted on June 4, 2018.
/s/ Christina Flint, by Power of Attorney 02/06/2020
** 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 4 (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).
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