0001104659-21-122560.txt : 20211004
0001104659-21-122560.hdr.sgml : 20211004
20211004170248
ACCESSION NUMBER: 0001104659-21-122560
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210930
FILED AS OF DATE: 20211004
DATE AS OF CHANGE: 20211004
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Pruzanski Mark
CENTRAL INDEX KEY: 0001559569
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35668
FILM NUMBER: 211303729
MAIL ADDRESS:
STREET 1: C/O INTERCEPT PHARMACEUTICALS, INC.
STREET 2: 18 DESBROSSES ST.
CITY: NEW YORK
STATE: NY
ZIP: 10013
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: 10 HUDSON YARDS, 37TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10001
BUSINESS PHONE: 646-747-1000
MAIL ADDRESS:
STREET 1: 10 HUDSON YARDS, 37TH FLOOR
CITY: New York
STATE: NY
ZIP: 10001
FORMER COMPANY:
FORMER CONFORMED NAME: INTERCEPT PHARMACEUTICALS INC
DATE OF NAME CHANGE: 20031113
4
1
tm2129223-1_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-09-30
0
0001270073
INTERCEPT PHARMACEUTICALS, INC.
ICPT
0001559569
Pruzanski Mark
C/O INTERCEPT PHARMACEUTICALS, INC.
10 HUDSON YARDS, FLOOR 37
NEW YORK
NY
10001
1
0
0
0
Common Stock
2021-09-30
4
A
0
6136
14.85
A
618068
D
Common Stock
2021-09-30
4
F
0
3816
14.85
D
614252
D
Represents shares of common stock delivered in respect of performance stock unit awards previously granted to the reporting person; such delivery being made pursuant to the Retirement and Consulting Agreement by and between the Issuer and the reporting person, dated December 9, 2020.
Represents shares of common stock withheld by the Issuer to satisfy taxes associated with the partial vesting of restricted stock unit and performance stock unit awards previously granted to the reporting person.
/s/ Mary J. Grendell, as attorney-in-fact
2021-10-04