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