0001400482-16-000220.txt : 20160818 0001400482-16-000220.hdr.sgml : 20160818 20160818185324 ACCESSION NUMBER: 0001400482-16-000220 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160818 FILED AS OF DATE: 20160818 DATE AS OF CHANGE: 20160818 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ACUCELA INC. CENTRAL INDEX KEY: 0001400482 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 020592619 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1301 SECOND AVE. STREET 2: SUITE 4200 CITY: SEATTLE STATE: WA ZIP: 98101 BUSINESS PHONE: 206-805-8300 MAIL ADDRESS: STREET 1: 1301 SECOND AVE. STREET 2: SUITE 4200 CITY: SEATTLE STATE: WA ZIP: 98101 FORMER COMPANY: FORMER CONFORMED NAME: Acucela Inc DATE OF NAME CHANGE: 20070523 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DANSE EDWARD H CENTRAL INDEX KEY: 0001016353 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55133 FILM NUMBER: 161841765 MAIL ADDRESS: STREET 1: 2525 DUPONT DRIVE CITY: IRVINE STATE: CA ZIP: 92715 4 1 wf-form4_147156079145667.xml FORM 4 X0306 4 2016-08-18 0 0001400482 ACUCELA INC. M?????? 0001016353 DANSE EDWARD H C/O ACUCELA INC. 1301 2ND AVE., SUITE 4200 SEATTLE WA 98101 0 1 0 0 Chief Business Officer Common Stock 2016-08-18 4 M 0 75101 5.48 A 181493 D Common Stock 2016-08-18 4 S 0 75101 10.81 D 106392 D Stock Option (right to buy) 5.48 2016-08-18 4 M 0 75101 0 D 2025-05-01 Common Stock 75101.0 165222 D The issuer's common stock trades on the Tokyo Stock Exchange under the symbol referenced in the issuer's registration statement on Form S-1 (File No. 333-192900). The shares were sold at a price of 1082 Japanese Yen. The U.S. per share price in this Column 4 reflects the average of the buy and sell Japanese Yen-to U.S. Dollar exchange rates on the transaction date divided by the number of shares sold. These shares were sold in multiple transactions at prices ranging from 1054 to 1120 Japanese Yen, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the SEC staff, upon request, full information regarding the number of shares sold at each separate price within the range set forth herein. The exercise price of the stock options is the closing price of the Issuer's common stock on May 7, 2015, which is the first trading day of the Issuer's common stock on the Tokyo Stock Exchange following the May 1, 2015 grant date. Twenty-five percent (25%) of the shares subject to the option vest on 5/1/2016, and the remaining 75% of the shares subject to the option vest on a monthly basis over the following three years, with 100% vested and exercisable on 5/1/2019, subject to the optionee's provision of service to the Issuer on each such vesting date. /s/ John Gebhart as attorney-in-fact for Edward Danse 2016-08-18