0001415889-22-002122.txt : 20220302 0001415889-22-002122.hdr.sgml : 20220302 20220302151225 ACCESSION NUMBER: 0001415889-22-002122 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220301 FILED AS OF DATE: 20220302 DATE AS OF CHANGE: 20220302 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JOBES ELIZABETH VARKI CENTRAL INDEX KEY: 0001547911 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35182 FILM NUMBER: 22702963 MAIL ADDRESS: STREET 1: 640 LEE ROAD CITY: CHESTERBROOK STATE: PA ZIP: 19087 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 form4-03022022_120358.xml X0306 4 2022-03-01 0001411906 Ampio Pharmaceuticals, Inc. AMPE 0001547911 JOBES ELIZABETH VARKI C/O AMPIO PHARMACEUTICALS, INC. 373 INVERNESS PARKWAY, SUITE 200 ENGLEWOOD CO 80112 true false false false Stock Option (Right to Buy) 0.4513 2022-03-01 4 A 0 150000 0 A 2032-02-24 Common Stock 150000 150000 D The stock options vest as to 1/36 of the underlying shares monthly on the 24th day of each month for three years (until February 24, 2025). The vesting commencement date is February 24, 2022 /s/ Dan Stokely, Attorney-in-Fact 2022-03-02