SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Fort John G.

(Last) (First) (Middle)
POZEN INC.
1414 RALEIGH ROAD, SUITE 400

(Street)
CHAPEL HILL NC 27517

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/10/2009
3. Issuer Name and Ticker or Trading Symbol
POZEN INC /NC [ POZN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Medical Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 2,000 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (1) 07/16/2017 Common Stock 40,000 $19.21 D
Stock Option (Right to Buy) (2) 03/14/2018 Common Stock 6,000 $10.2 D
Stock Option (Right to Buy) (3) 05/06/2018 Common Stock 15,000 $14.45 D
Stock Option (Right to Buy) (4) 03/13/2019 Common Stock 15,000 $5.66 D
Explanation of Responses:
1. The option vests in four equal annual installments, with the initial vesting date occurring on July 16, 2008.
2. The option vests in four equal annual installments, with the initial vesting date occurring on March 14, 2009.
3. The option vests as follows: twenty-five percent (25%) vested upon the acceptance by the U.S. Food and Drug Administration (FDA) of the New Drug Application (NDA) for VIMOVO in September 2009; the remaining seventy-five (75%) will vest upon the receipt by the Company of an action letter from the FDA indicating approval of the NDA for VIMOVO. The option also includes provisions that require satisfactory employee performance prior to vesting.
4. The option vests in four equal annual installments, with the initial vesting date occurring on March 13, 2010.
Remarks:
On December 10, 2009, Dr. Fort was employed by POZEN, Inc. (the ?Company?), and had previously been employed by the Company, as its Chief Medical Officer. In connection with his prior employment, Dr. Fort was granted stock options to purchase shares of the Company?s Common Stock at an exercise price equal to the fair market value on the specific dates of the individual grants.
John E. Barnhardt, Attorney-in-fact 12/15/2009
** 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 5 (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.
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