SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Mahmood Tahir Ph.D.

(Last) (First) (Middle)
C/O APPLIED MOLECULAR TRANSPORT INC.
450 EAST JAMIE COURT

(Street)
SOUTH SAN FRANCISCO CA 94080

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Applied Molecular Transport Inc. [ AMTI ]
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
3. Date of Earliest Transaction (Month/Day/Year)
02/15/2022
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/15/2022 A 75,000(1) A $0.00 78,000 D
Common Stock 176,657 I By Irrevocable Trust(2)
Common Stock 334,632 I By GRAT(3)
Common Stock 3,088,711 I By Living Trust(4)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: 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) $8.29 02/15/2022 A 350,000 03/15/2022(5) 02/15/2032 Common Stock 350,000 $0.00 350,000 D
Explanation of Responses:
1. These securities are Restricted Stock Units (RSUs). Each RSU represents a contingent right to receive one shares of the Issuer's Common Stock. 5/48ths of the RSUs shall vest on June 1, 2022 and 1/16th of the RSUs shall vest quarterly thereafter, subject to the Reporting Person continuing as a service provider through each such date.
2. These shares are held directly by The Mahmood 2017 Irrevocable Trust for which the Reporting Person serves as trustee and over which shares the Reporting Person hold voting and dispositive power.
3. These shares are held directly by the Tahir Mahmood 2019 Annuity Trust for which the Reporting Person serves as trustee and over which shares the Reporting Person holds voting and dispositive power.
4. These shares are held directly by the Mrsny-Daugherty Living Trust for which the Reporting Person and his spouse are co-trustees, and over which the Reporting Person and his spouse hold voting and dispositive power.
5. 1/48th of the shares subject to the option shall become vested and exercisable on the Exercisable Date set forth above and 1/48th of the shares subject to the option shall continue to vest each month thereafter, provided that Reporting Person is a service provider to the Issuer as of each such vesting date.
Remarks:
/s/ Brandon Hants Attorney-in-Fact for Tahir Mahmood 02/16/2022
** 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 Number.