0001104659-21-075217.txt : 20210601
0001104659-21-075217.hdr.sgml : 20210601
20210601190139
ACCESSION NUMBER: 0001104659-21-075217
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210527
FILED AS OF DATE: 20210601
DATE AS OF CHANGE: 20210601
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ROSA-BJORKESON DAGMAR
CENTRAL INDEX KEY: 0001643934
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35668
FILM NUMBER: 21987062
MAIL ADDRESS:
STREET 1: C/O BAXALTA INCORPORATED
STREET 2: 1200 LAKESIDE DRIVE
CITY: BANNOCKBURN
STATE: IL
ZIP: 60015
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
tm2118118-4_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-05-27
0
0001270073
INTERCEPT PHARMACEUTICALS, INC.
ICPT
0001643934
ROSA-BJORKESON DAGMAR
C/O INTERCEPT PHARMACEUTICALS, INC.
10 HUDSON YARDS, FLOOR 37
NEW YORK
NY
10001
1
0
0
0
Common Stock
2021-05-27
4
A
0
10543
0
A
10543
D
Option to Purchase Common Stock
17.08
2021-05-27
4
A
0
17719
0
A
2031-05-27
Common Stock
17719
17719
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. 1/3rd of the shares subject to the award shall vest on each anniversary of the Vesting Commencement Date (or, if earlier in any given year, the day immediately preceding the date of the Issuer's Annual Meeting of Stockholders in such year). The Vesting Commencement Date is April 1, 2021.
1/3rd of the options subject to the award shall vest and become exercisable on each anniversary of the Vesting Commencement Date (or, if earlier in any given year, the day immediately preceding the date of the Issuer's Annual Meeting of Stockholders in such year). The Vesting Commencement Date is April 1, 2021.
/s/ Mary J. Grendell, as attorney-in-fact
2021-06-01