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