0001144204-15-068399.txt : 20151127
0001144204-15-068399.hdr.sgml : 20151126
20151127210238
ACCESSION NUMBER: 0001144204-15-068399
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151124
FILED AS OF DATE: 20151127
DATE AS OF CHANGE: 20151127
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: INTERCEPT PHARMACEUTICALS INC
CENTRAL INDEX KEY: 0001270073
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 223868459
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 450 W. 15TH STREET
STREET 2: SUITE 505
CITY: NEW YORK
STATE: NY
ZIP: 10011
BUSINESS PHONE: 646-747-1000
MAIL ADDRESS:
STREET 1: 450 W. 15TH STREET
STREET 2: SUITE 505
CITY: New York
STATE: NY
ZIP: 10011
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SILVERSTEIN JONATHAN
CENTRAL INDEX KEY: 0001171005
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35668
FILM NUMBER: 151258399
MAIL ADDRESS:
STREET 1: 601 LEXINGTON AVENUE
STREET 2: 54TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
4
1
v425727_4.xml
OWNERSHIP DOCUMENT
X0306
4
2015-11-24
0
0001270073
INTERCEPT PHARMACEUTICALS INC
ICPT
0001171005
SILVERSTEIN JONATHAN
C/O INTERCEPT PHARMACEUTICALS, INC.
450 W. 15TH STREET, SUITE 505
NEW YORK
NY
10011
1
0
0
0
Common Stock
2015-11-24
4
A
0
650
0
A
1259
D
Common Stock
1120324
I
See footnote
Option to Purchase Common Stock
183.62
2015-11-24
4
A
0
1750
0
A
2025-11-24
Common Stock
1750
1750
D
100% of the shares of restricted stock will vest on November 24, 2016, the one year anniversary of the grant date, subject to the terms and conditions of the award and the Intercept Pharmaceuticals, Inc. 2012 Equity Incentive Plan (the "2012 Plan"); provided, however, that if the date of the 2016 annual meeting of stockholders is held prior to the one year anniversary date from the grant, the shares of restricted stock shall vest as of the close of business on the day immediately preceding such annual meeting date, subject to the director's continued service on the issuer's board of directors.
100% of the shares underlying this option (i.e. 1,750 shares) will vest on November 24, 2016, the one year anniversary of the grant date, subject to the terms and conditions of the award and the 2012 Plan; provided, however, that if the date of the 2016 annual meeting of stockholders is held prior to the one year anniversary date from the grant, the shares underlying the option shall vest as of the close of business on the day immediately preceding such annual meeting date, subject to the director's continued service on the issuer's board of directors.
These shares are held of record by OPI IV. OrbiMed Capital GP IV LLC ("GP IV") is the general partner of OPI IV and Advisors is the managing member of GP IV LLC. Samuel D. Isaly ("Isaly") is the managing member of and owner of a controlling interest in Advisors and may be deemed to have voting and investment power over the shares held by OPI IV. The reporting person is a member of Advisors. Each of GP IV, Advisors, Isaly and the reporting person disclaims beneficial ownership of the securities reported herein for purposes of Rule 16a-1(a) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), except to the extent of its or his pecuniary interest therein, if any. This report shall not be deemed an admission that any such person is a beneficial owner for the purpose of Section 16 of the Exchange Act, or for any other purpose.
/s/ Bryan Yoon, as attorney-in-fact
2015-11-27