0001415889-21-005018.txt : 20211028
0001415889-21-005018.hdr.sgml : 20211028
20211028203233
ACCESSION NUMBER: 0001415889-21-005018
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211027
FILED AS OF DATE: 20211028
DATE AS OF CHANGE: 20211028
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Cherevka Holli
CENTRAL INDEX KEY: 0001717673
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35182
FILM NUMBER: 211360141
MAIL ADDRESS:
STREET 1: C/O AMPIO PHARMACEUTICALS, INC.
STREET 2: 373 IVERNESS PARKWAY
CITY: ENGLEWOOD
STATE: CO
ZIP: 80112
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
form4-10282021_051021.xml
X0306
4
2021-10-27
0001411906
Ampio Pharmaceuticals, Inc.
AMPE
0001717673
Cherevka Holli
C/O AMPIO PHARMACEUTICALS, INC.
373 INVERNESS PARKWAY, SUITE 200
ENGLEWOOD
CO
80112
false
true
false
false
PRESIDENT AND COO
Common Stock
2021-10-27
4
F
0
41980
1.64
D
458020
D
/s/ Daniel Stokely, Attorney-in-Fact
2021-10-28