0001104659-19-062781.txt : 20191112 0001104659-19-062781.hdr.sgml : 20191112 20191112190021 ACCESSION NUMBER: 0001104659-19-062781 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191108 FILED AS OF DATE: 20191112 DATE AS OF CHANGE: 20191112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ford David A CENTRAL INDEX KEY: 0001705295 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35668 FILM NUMBER: 191211316 MAIL ADDRESS: STREET 1: 7 OAKRIDGE ROAD CITY: ANNANDALE STATE: NJ ZIP: 08801 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INTERCEPT PHARMACEUTICALS, INC. CENTRAL INDEX KEY: 0001270073 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 223868459 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10 HUDSON YARDS, 37TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10001 BUSINESS PHONE: 646-747-1000 MAIL ADDRESS: STREET 1: 10 HUDSON YARDS, 37TH FLOOR CITY: New York STATE: NY ZIP: 10001 FORMER COMPANY: FORMER CONFORMED NAME: INTERCEPT PHARMACEUTICALS INC DATE OF NAME CHANGE: 20031113 4 1 tm1922493d1_4.xml OWNERSHIP DOCUMENT X0306 4 2019-11-08 0 0001270073 INTERCEPT PHARMACEUTICALS, INC. ICPT 0001705295 Ford David A C/O INTERCEPT PHARMACEUTICALS, INC. 10 HUDSON YARDS, FLOOR 37 NEW YORK NY 10001 0 1 0 0 Chief Human Resources Officer Common Stock 2019-11-08 4 F 0 128 82.76 D 11268 D Represents shares of common stock withheld by the Issuer to satisfy taxes associated with the partial vesting of a restricted stock award previously granted to the reporting person. /s/ Mark Pruzanski, as attorney-in-fact 2019-11-12