0001415889-21-004869.txt : 20211013
0001415889-21-004869.hdr.sgml : 20211013
20211013193555
ACCESSION NUMBER: 0001415889-21-004869
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211011
FILED AS OF DATE: 20211013
DATE AS OF CHANGE: 20211013
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: 211322241
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
form4-10132021_041049.xml
X0306
4
2021-10-11
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
2021-10-11
4
A
0
335000
0
A
363315
D
/s/ Daniel Stokely
2021-10-13