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*
Campbell Elizabeth S

(Last) (First) (Middle)
1 WEST FIRST AVENUE

(Street)
CONSHOHOCKEN PA 19428

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/01/2021
3. Issuer Name and Ticker or Trading Symbol
AMERISOURCEBERGEN CORP [ ABC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Executive Vice President
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 4,551.177 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
Non-qualified Stock Option (Right to Buy) (1) 11/11/2022 Common Stock 3,349 $98.24 D
Non-qualified Stock Option (Right to Buy) (2) 11/09/2023 Common Stock 7,380 $75.61 D
Non-qualified Stock Option (Right to Buy) (3) 11/15/2024 Common Stock 6,610 $77.53 D
Non-qualified Stock Option (Right to Buy) (4) 11/14/2025 Common Stock 5,162 $89.58 D
Restricted Stock Units (5) (5) Common Stock 4,182 $0 D
Restricted Stock Units (6) (6) Common Stock 3,562 $0 D
Restricted Stock Units (7) (7) Common Stock 4,668 $0 D
Restricted Stock Units (8) (8) Common Stock 1,429 $0 D
Explanation of Responses:
1. Exerciseable in four equal annual installments on 11/11/16, 11/11/17, 11/11/18 and 11/11/19.
2. Exercisable in four equal annual installments on 11/9/17, 11/9/18, 11/9/19 and 11/9/20.
3. Exercisable in four equal annual installments on 11/15/18, 11/15/19, 11/15/20 and 11/15/21.
4. Exercisable in four equal annual installments on 11/14/19, 11/14/20, 11/14/21 and 11/14/22.
5. Grant of restricted stock units received for no consideration and vests 100% on 11/13/2022.
6. Grant of restricted stock units received for no consideration that vest in three equal annual installments on 11/10/2021, 11/10/2022, and 11/10/2023.
7. Grant of restricted stock units received for no consideration and vests 100% on 2/3/2023.
8. Grant of restricted stock units received for no consideration and vests 100% on 11/14/2021.
Remarks:
Exhibit List: Exhibit 24 - Power of Attorney
/s/ John G. Chou, attorney-in-fact for Elizabeth S. Campbell 09/13/2021
** 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.
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.