0001415889-21-002569.txt : 20210519 0001415889-21-002569.hdr.sgml : 20210519 20210519175620 ACCESSION NUMBER: 0001415889-21-002569 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210517 FILED AS OF DATE: 20210519 DATE AS OF CHANGE: 20210519 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STOKELY DAN CENTRAL INDEX KEY: 0001277543 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35182 FILM NUMBER: 21941564 MAIL ADDRESS: STREET 1: 4810 EASTGATE MALL 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 form4-05192021_020507.xml X0306 4 2021-05-17 0001411906 Ampio Pharmaceuticals, Inc. AMPE 0001277543 STOKELY DAN C/O AMPIO PHARMACEUTICALS, INC. 373 INVERNESS PARKWAY, SUITE 200 ENGLEWOOD CO 80112 false true false false CFO Common Stock 2021-05-17 4 M 0 35000 0.43 A 63315 D Common Stock 2021-05-18 4 S 0 35000 1.828 D 28315 D Stock Option (Right to Buy) 0.43 2021-05-17 4 M 0 35000 0 D 2029-08-20 Common Stock 35000 283000 D Options were previously reported on a Form 4 dated August 22, 2019, where 50% of the stock option award vested and became exercisable on the date of grant, and the remaining 50% of the stock option award vested and became exercisable on July 31, 2020. /s/ Daniel Stokely 2021-05-19