Statement of Changes in Beneficial Ownership (4)
26 January 2022 - 8:58AM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Francois Cedric |
2. Issuer Name and Ticker or Trading Symbol
Apellis Pharmaceuticals, Inc.
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APLS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Executive Officer |
(Last)
(First)
(Middle)
C/O APELLIS PHARMACEUTICALS, INC., 100 FIFTH AVENUE, 3RD FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/21/2022 |
(Street)
WALTHAM, MA 02451
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 1/21/2022 | | A | | 106244 (1) | A | $0 | 1340487 | D | |
Common Stock | | | | | | | | 234411 | I | See Footnote (2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (Right to Buy) | $35.46 | 1/21/2022 | | A | | 150672 | | (3) | 1/20/2032 | Common Stock | 150672 | $0 | 150672 | D | |
Explanation of Responses: |
(1) | This represents a restricted stock unit grant made on January 21, 2022 that vests 25% annually in equal installments over four years from the date of grant, subject to continued service. |
(2) | The securities are held by The Francois-DuBois Educational Trust (the "Trust"), for which the Fiduciary Trust Company of New England serves as trustee. The reporting person disclaims beneficial ownership over the shares held by the Trust except to the extent of his pecuniary interest therein. |
(3) | This represents a non-qualified stock option grant made on January 21, 2022 that vests over a four year period with 25% vesting one year from grant date and the remaining 75% vesting in equal monthly installments thereafter through the fourth anniversary of the grant date, subject to continued service. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Francois Cedric C/O APELLIS PHARMACEUTICALS, INC. 100 FIFTH AVENUE, 3RD FLOOR WALTHAM, MA 02451 | X |
| Chief Executive Officer |
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Signatures
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/s/David Watson, attorney-in-fact for Cedric Francois | | 1/25/2022 |
**Signature of Reporting Person | Date |
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