Statement of Changes in Beneficial Ownership (4)
03 December 2022 - 9:05AM
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).
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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
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Kurzius Lawrence Erik |
2. Issuer Name and Ticker or Trading Symbol
Elanco Animal Health Inc
[
ELAN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O ELANCO ANIMAL HEALTH INCORPORATED, 2500 INNOVATION WAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/30/2022 |
(Street)
GREENFIELD, IN 46140
(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 | 11/30/2022 | | A | | 18649 | A | $0 (1) | 52916 | D | |
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 |
Deferred Stock Units (2)(3) | (4) | 11/30/2022 | | A | | 712.2510 | | (2) | (2) | Common Stock | 712.2510 | $12.87 (3)(4) | 14464.4313 | D | |
Explanation of Responses: |
(1) | Grant of deferred stock units as an annual equity award to each of the non-employee members of the Issuer's Board of Directors. |
(2) | Mr. Kurzius elected to defer his director cash retainer fees pursuant to the Company's Directors' Deferral Plan (the "Plan") and such deferred fees were credited to the Elanco Deferred Stock Account under the Plan. Each Deferred Stock Unit is the economic equivalent of one share of Elanco common stock. |
(3) | The Deferred Stock Units will be settled in stock following the reporting person's separation of service from the Company's Board of Directors pursuant to the Plan. |
(4) | The number of Deferred Stock Units issued is the amount of cash compensation deferred divided by the closing price of a share of Elanco common stock on the grant date, which was $12.87 on November 30, 2022. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Kurzius Lawrence Erik C/O ELANCO ANIMAL HEALTH INCORPORATED 2500 INNOVATION WAY GREENFIELD, IN 46140 | X |
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Signatures
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/s/ Marcela A. Kirberger, as Attorney-in-Fact for Lawrence Kurzius | | 12/2/2022 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
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