0001062993-23-015000.txt : 20230718 0001062993-23-015000.hdr.sgml : 20230718 20230718163714 ACCESSION NUMBER: 0001062993-23-015000 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20230714 FILED AS OF DATE: 20230718 DATE AS OF CHANGE: 20230718 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Derby Michael CENTRAL INDEX KEY: 0001809613 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35776 FILM NUMBER: 231094736 MAIL ADDRESS: STREET 1: 303 SOUTH BROADWAY STREET 2: SUITE 125 CITY: TARRYTOWN STATE: NY ZIP: 10591 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Acasti Pharma Inc. CENTRAL INDEX KEY: 0001444192 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: A8 FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 3009, BOUL. DE LA CONCORDE EAST STREET 2: SUITE 102 CITY: LAVAL STATE: A8 ZIP: H7E 2B5 BUSINESS PHONE: 450-686-4555 MAIL ADDRESS: STREET 1: 3009, BOUL. DE LA CONCORDE EAST STREET 2: SUITE 102 CITY: LAVAL STATE: A8 ZIP: H7E 2B5 4 1 form4.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0508 4 2023-07-14 0001444192 Acasti Pharma Inc. ACST 0001809613 Derby Michael C/O ACASTI PHARMA INC. 3009 BOUL. DE LA CONCORDE EAST SUITE 102 LAVAL A8 H7E 2B5 QUEBEC, CANADA 1 0 0 0 0 Stock Options (Right to Buy) 2.64 2023-07-14 4 A 0 12500 0 A 2033-07-14 Class A Common Shares 12500 12500 D Stock options granted on 07/14/2023 under the Acasti Pharma Stock Option Plan, which vest and become exercisable in equal monthly installments over a period of 12 months. Exhibit 24, Power of Attorney, is attached. /s/ Prashant Kohli, as attorney-in-fact 2023-07-18 EX-24 2 exhibit24.htm POWER OF ATTORNEY
Exhibit 24.1
LIMITED POWER OF ATTORNEY
FOR SECTION 16 REPORTING OBLIGATIONS

Know all by these presents, that the undersigned hereby makes, constitutes and appoints each of Prashant Kohli and Tiffany Smith, signing singly and each acting individually, as the undersigned’s true and lawful attorney‑in‑fact with full power and authority as hereinafter described to:
 
(1)            execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of Acasti Pharma Inc. (the “Company”), Forms 3, 4, and 5 (including any amendments thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended, and the rules thereunder (the “Exchange Act”);
 
(2)            do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to prepare, complete and execute any such Form 3, 4, or 5, prepare, complete and execute any amendment or amendments thereto, and timely deliver and file such form with the United States Securities and Exchange Commission (the “SEC”) and any stock exchange or similar authority, including without limitation the filing of a Form ID, Update Passphrase, or any other application materials to enable the undersigned to gain or maintain access to the Electronic Data Gathering, Analysis and Retrieval system of the SEC;
 
(3)            seek or obtain, as the undersigned’s representative and on the undersigned’s behalf, information regarding transactions in the Company’s securities from any third party, including brokers, employee benefit plan administrators and trustees, and the undersigned hereby authorizes any such person to release any such information to such attorney‑in‑fact and approves and ratifies any such release of information; and
 
(4)            take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney‑in‑fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney‑in‑fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney‑in‑fact may approve in such attorney‑in‑fact’s discretion.
 
The undersigned hereby grants to each such attorney‑in‑fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney‑in‑fact, or such attorney‑in‑fact’s substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys‑in‑fact, in serving in such capacity at the request of the undersigned, are not assuming nor relieving, nor is the Company assuming nor relieving, any of the undersigned’s responsibilities to comply with Section 16 of the Exchange Act. The undersigned acknowledges that neither the Company nor the foregoing attorneys‑in‑fact assume (i) any liability for the undersigned’s responsibility to comply with the requirements of the Exchange Act, (ii) any liability of the undersigned for any failure to comply with such requirements, or (iii) any obligation or liability of the undersigned for profit disgorgement under Section 16(b) of the Exchange Act.
 
This Power of Attorney revokes all previous Powers of Attorney with respect to the matters expressed herein.
 
This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned’s holdings of and transactions in securities issued by the Company, (b) revocation by the undersigned in a signed writing filed with the SEC or delivered to the foregoing attorneys‑in‑fact or the Company, or (c) as to any attorney-in-fact individually, until such attorney-in-fact is (x) no longer employed by the Company or (y) no longer an attorney representing the Company with respect to matters related to this Power of Attorney.
 
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 17th day of July, 2023.

 /s/ Michael Derby           
Michael Derby