0001104659-21-038580.txt : 20210318
0001104659-21-038580.hdr.sgml : 20210318
20210318211146
ACCESSION NUMBER: 0001104659-21-038580
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210316
FILED AS OF DATE: 20210318
DATE AS OF CHANGE: 20210318
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Luo Mary Z.
CENTRAL INDEX KEY: 0001611156
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36509
FILM NUMBER: 21756252
MAIL ADDRESS:
STREET 1: 11570 6TH STREET
CITY: RANCHO CUCAMONGA
STATE: CA
ZIP: 91730
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Zhang Jack Y.
CENTRAL INDEX KEY: 0001611157
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36509
FILM NUMBER: 21756253
MAIL ADDRESS:
STREET 1: 11570 6TH STREET
CITY: RANCHO CUCAMONGA
STATE: CA
ZIP: 91730
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Amphastar Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001297184
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 330702205
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 11570 SIXTH STREET
CITY: RANCHO CUCAMONGA
STATE: CA
ZIP: 91730
BUSINESS PHONE: 909-980-9484
MAIL ADDRESS:
STREET 1: 11570 SIXTH STREET
CITY: RANCHO CUCAMONGA
STATE: CA
ZIP: 91730
4
1
tm2110244-4_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-03-16
0
0001297184
Amphastar Pharmaceuticals, Inc.
AMPH
0001611157
Zhang Jack Y.
C/O AMPHASTAR PHARMACEUTICALS, INC.
11570 6TH STREET
RANCHO CUCAMONGA
CA
91730
1
1
1
0
CEO & Chief Scientific Officer
0001611156
Luo Mary Z.
C/O AMPHASTAR PHARMACEUTICALS, INC.
11570 6TH STREET
RANCHO CUCAMONGA
CA
91730
1
1
1
0
COO,Chief Scientist & Chairman
Common Stock
2021-03-16
4
F
0
25241
18.44
D
2193659
D
Common Stock
2021-03-16
4
F
0
8890
18.44
D
1431479
I
See footnote
Common Stock
2021-03-17
4
A
0
127209
0.00
A
2320868
D
Common Stock
2021-03-17
4
A
0
56892
0.00
A
1488371
I
See footnote
Common Stock
6827679
I
See footnote
Common Stock
5000
I
See footnote
Employee Stock Option (right to buy)
17.99
2021-03-17
4
A
0
298688
0
A
2031-03-17
Common Stock
298688
298688
D
Employee Stock Option (right to buy)
17.99
2021-03-17
4
A
0
133585
0
A
2031-03-17
Common Stock
133585
133585
I
See footnote
The reported shares were withheld to satisfy the reporting person's tax liability in connection with the vesting of restricted stock units, or RSUs.
The securities are held of record by Mary Z. Luo. The reporting persons are husband and wife.
The reported shares are represented by RSUs which vest in four equal annual installments beginning on March 17, 2022.
The shares are held of record by Applied Physics & Chemistry Laboratories, Inc., of which the reporting persons and The Bill Luobei Zhang 2004 Irrevocable Trust are the sole owners.
The shares are held of record in an account for the benefit of the reporting persons' son. The reporting persons disclaim beneficial ownership of these shares, and the inclusion of these shares in this report should not be deemed an admission of beneficial ownership of any such shares for purposes of Section 16, or for any other purpose.
Shares subject to the option vest in four equal annual installments beginning on March 17, 2022.
Excludes 200,000 shares previously reported as held indirectly by The Bill Luobei Zhang 2004 Irrevocable Trust. The reporting persons hold no beneficial ownership of these shares.
/s/ Eva Wen, by power of attorney for Jack Y. Zhang
2021-03-18
/s/ Eva Wen, by power of attorney for Mary Z. Luo
2021-03-18