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