0001570562-22-000053.txt : 20220126 0001570562-22-000053.hdr.sgml : 20220126 20220126210252 ACCESSION NUMBER: 0001570562-22-000053 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220124 FILED AS OF DATE: 20220126 DATE AS OF CHANGE: 20220126 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Avelar Rui CENTRAL INDEX KEY: 0001432063 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38381 FILM NUMBER: 22559638 MAIL ADDRESS: STREET 1: 1618 STATION STREET CITY: VANCOUVER STATE: A1 ZIP: V6A 1B6 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Evolus, Inc. CENTRAL INDEX KEY: 0001570562 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 461385614 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 520 NEWPORT CENTER DRIVE STREET 2: SUITE 1200 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 BUSINESS PHONE: (949) 284-4555 MAIL ADDRESS: STREET 1: 520 NEWPORT CENTER DRIVE STREET 2: SUITE 1200 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 4 1 wf-form4_164324895584499.xml FORM 4 X0306 4 2022-01-24 0 0001570562 Evolus, Inc. EOLS 0001432063 Avelar Rui 520 NEWPORT CENTER DR. SUITE 1200 NEWPORT BEACH CA 92660 0 1 0 0 See Remarks Common Stock 2022-01-24 4 A 0 53571 0 A 263381 D Stock Option (Right to Buy) 5.46 2022-01-24 4 A 0 77640 0 A 2032-01-25 Common Stock 77640.0 77640 D Represents shares issuable on settlement of restricted stock units ("RSUs") granted to the reporting person. Each RSU represents a contingent right to receive one share of the Issuer's common stock. The RSUs will vest over a period of four years, with 1/4th of the RSU vesting annually on the anniversary of January 24, 2022, provided the reporting person remains in continuous service on each vesting date, subject to accelerated vesting in certain events, including certain terminations of the reporting person or upon certain changes of control of the issuer. The shares subject to the option will vest over a period of four years, with 1/4th of the shares subject to the option vesting annually on the anniversary of January 24, 2022, provided the reporting person remains in continuous service on each vesting date, subject to accelerated vesting in certain events, including certain terminations of the reporting person or upon certain changes of control of the issuer. Chief Medical Officer and Head of Research & Development /s/ Jeffrey J. Plumer, as attorney-in-fact for Rui Avelar 2022-01-26