0001104659-20-007268.txt : 20200127 0001104659-20-007268.hdr.sgml : 20200127 20200127190747 ACCESSION NUMBER: 0001104659-20-007268 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200123 FILED AS OF DATE: 20200127 DATE AS OF CHANGE: 20200127 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pruzanski Mark CENTRAL INDEX KEY: 0001559569 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35668 FILM NUMBER: 20551031 MAIL ADDRESS: STREET 1: C/O INTERCEPT PHARMACEUTICALS, INC. STREET 2: 18 DESBROSSES ST. CITY: NEW YORK STATE: NY ZIP: 10013 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 tm205922d9_4.xml OWNERSHIP DOCUMENT X0306 4 2020-01-23 0 0001270073 INTERCEPT PHARMACEUTICALS, INC. ICPT 0001559569 Pruzanski Mark C/O INTERCEPT PHARMACEUTICALS, INC. 10 HUDSON YARDS, FLOOR 37 NEW YORK NY 10001 1 1 0 0 President & CEO Common Stock 2020-01-23 4 A 0 10800 0 A 477629 D Common Stock 100000 I By GRAT Option to Purchase Common Stock 99.66 2020-01-23 4 A 0 17700 0 A 2030-01-23 Common Stock 17700 17700 D Represents restricted stock units granted to the Reporting Person. Each restricted stock unit represents a contingent right to receive one share of the Issuer's Common Stock. The award shall be subject to a four-year vesting period, with the shares subject to the award vesting in four equal annual installments following the Vesting Commencement Date. The Vesting Commencement Date is January 1, 2020. The award shall be subject to a four-year vesting period, with 25% of the shares subject to the award vesting and becoming exercisable in an initial annual installment following the Vesting Commencement Date and 1/48th of the shares subject to the award vesting and becoming exercisable each month thereafter. The Vesting Commencement Date is January 1, 2020. /s/ Mark Pruzanski 2020-01-27