0001144204-16-114011.txt : 20160721 0001144204-16-114011.hdr.sgml : 20160721 20160721210418 ACCESSION NUMBER: 0001144204-16-114011 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160719 FILED AS OF DATE: 20160721 DATE AS OF CHANGE: 20160721 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: SANTINI GINO CENTRAL INDEX KEY: 0001276038 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35668 FILM NUMBER: 161778380 MAIL ADDRESS: STREET 1: C/O AMAG PHARMACEUTICALS, INC. STREET 2: 1100 WINTER STREET CITY: WALTHAM STATE: MA ZIP: 02451 4 1 v444668_4.xml OWNERSHIP DOCUMENT X0306 4 2016-07-19 0 0001270073 INTERCEPT PHARMACEUTICALS INC ICPT 0001276038 SANTINI GINO C/O INTERCEPT PHARMACEUTICALS, INC. 450 W. 15TH STREET, SUITE 505 NEW YORK NY 10011 1 0 0 0 Common Stock 2016-07-19 4 A 0 1204 0 A 2504 D Option to Purchase Common Stock 145.22 2016-07-19 4 A 0 1598 0 A 2026-07-19 Common Stock 1598 1598 D The 1,204 shares of restricted stock and the shares of 1,598 shares of common stock underlying the option will each fully vest on the one-year anniversary of the date of grant (the "Anniversary Date"), subject to the terms and conditions of the award and the Intercept Pharmaceuticals, Inc. 2012 Equity Incentive Plan (the "2012 Plan"); provided, however, if the date of the next subsequent annual meeting of stockholders (starting from the 2017 annual meeting) is held prior to the Anniversary Date in that year, the annual vesting for such year shall occur on the day immediately preceding the date of the annual meeting in such year. /s/ Bryan Yoon, as attorney-in-fact 2016-07-21