0001209191-15-035357.txt : 20150421
0001209191-15-035357.hdr.sgml : 20150421
20150421184601
ACCESSION NUMBER: 0001209191-15-035357
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150421
FILED AS OF DATE: 20150421
DATE AS OF CHANGE: 20150421
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: KEMPHARM, INC
CENTRAL INDEX KEY: 0001434647
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 205894398
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2656 CROSSPARK ROAD, SUITE 100
CITY: CORALVILLE
STATE: IA
ZIP: 52241
BUSINESS PHONE: 319-665-2575
MAIL ADDRESS:
STREET 1: 2656 CROSSPARK ROAD, SUITE 100
CITY: CORALVILLE
STATE: IA
ZIP: 52241
FORMER COMPANY:
FORMER CONFORMED NAME: KEMPHARM INC
DATE OF NAME CHANGE: 20080507
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Plooster Matthew R
CENTRAL INDEX KEY: 0001638364
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36913
FILM NUMBER: 15784057
MAIL ADDRESS:
STREET 1: 2656 CROSSPARK ROAD
STREET 2: SUITE 100
CITY: CORALVILLE
STATE: IA
ZIP: 52241
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2015-04-21
0
0001434647
KEMPHARM, INC
KMPH
0001638364
Plooster Matthew R
C/O KEMPHARM, INC.
2656 CROSSPARK ROAD, SUITE 100
CORALVILLE
IA
52241
1
0
0
0
Common Stock
2015-04-21
4
C
0
4545
A
4545
D
Common Stock
2015-04-21
4
C
0
1117
A
1117
I
By TD Ameritrade Clearing Inc. Custodian FBO Matthew Ryan Plooster Roth IRA, as trustee
Common Stock
2015-04-21
4
C
0
428304
A
428304
I
By Bridgepoint Investment Partners I LLLP
Series C Convertible Preferred Stock
2015-04-21
4
C
0
25642
0.00
D
Common Stock
3418
0
D
Series D Convertible Preferred Stock
2015-04-21
4
C
0
8456
0.00
D
Common Stock
1127
0
D
Series C Convertible Preferred Stock
2015-04-21
4
C
0
8381
0.00
D
Common Stock
1117
0
I
By TD Ameritrade Clearing Inc. Custodian FBO Matthew Ryan Plooster Roth IRA, as trustee
Series A Convertible Preferred Stock
2015-04-21
4
C
0
1701011
0.00
D
Common Stock
226801
0
I
By Bridgepoint Investment Partners I LLLP
Series B Convertible Preferred Stock
2015-04-21
4
C
0
1511279
0.00
D
Common Stock
201503
0
I
By Bridgepoint Investment Partners I LLLP
Warrant to Purchase Series D Preferred Stock (right to buy)
2015-04-21
4
C
0
384
0.78
D
Common Stock
51
0
D
Warrant to Purchase Common Stock (right to buy)
5.85
2015-04-21
4
C
0
51
0.00
A
Common Stock
51
51
D
The total represents shares received upon conversion of Series C and Series D convertible preferred stock.
The total represents shares received upon conversion of Series C convertible preferred stock.
The total represents shares received upon conversion of Series A and Series B convertible preferred stock.
Effective upon the closing of the Issuer's initial public offering of its common stock, each share of Series A, Series B, Series C and Series D convertible preferred stock automatically converted into 0.13333 shares of common stock. The convertible preferred stock had no expiration date.
The shares directly held by Bridgepoint Investment Partners I LLLP, or Bridgepoint, are indirectly held by its general partner, Bridgepoint Capital Partners, LLP, or BPCP. The individual managers of BPCP are Matthew R. Plooster and Adam S. Claypool. Matthew R. Plooster and Adam S. Claypool share voting and dispositive power with regard to the shares directly held by Bridgepoint.
Represents a warrant to purchase shares of common stock of the Issuer following the conversion of the Series D convertible preferred stock on a 1-for-0.13333 share basis. The number of shares and price per share reported herein reflects such conversion. The warrant is immediately exercisable at any time at the option of the holder.
The warrant expires as of 5:00 p.m. C.S.T. on the earliest of (i) June 2, 2019 and (ii) the effective date of the closing of a Company Sale Transaction (as such term is defined in the warrant).
/s/ James C.T. Linfield, Attorney-in-Fact
2015-04-21