0001209191-22-005701.txt : 20220131
0001209191-22-005701.hdr.sgml : 20220131
20220131173824
ACCESSION NUMBER: 0001209191-22-005701
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20220127
FILED AS OF DATE: 20220131
DATE AS OF CHANGE: 20220131
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Smither John W
CENTRAL INDEX KEY: 0001559583
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39306
FILM NUMBER: 22575425
MAIL ADDRESS:
STREET 1: C/O KYTHERA BIOPHARMACEUTICALS, INC.
STREET 2: 27200 WEST AGOURA ROAD, SUITE 200
CITY: CALABASAS
STATE: CA
ZIP: 91301
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Applied Molecular Transport Inc.
CENTRAL INDEX KEY: 0001801777
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 814481426
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 450 EAST JAMIE COURT
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
BUSINESS PHONE: 650-392-0420
MAIL ADDRESS:
STREET 1: 450 EAST JAMIE COURT
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
FORMER COMPANY:
FORMER CONFORMED NAME: Applied Molecular Transport LLC
DATE OF NAME CHANGE: 20200130
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2022-01-27
1
0001801777
Applied Molecular Transport Inc.
AMTI
0001559583
Smither John W
C/O APPLIED MOLECULAR TRANSPORT INC.
450 EAST JAMES COURT
SO. SAN FRANCISCO
CA
94080
1
0
0
0
No securities held
[/s/ Brandon Hants Attorney-in-Fact John W. Smither]
2022-01-31
EX-24
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
The undersigned, as a Section 16 reporting person of Applied Molecular Transport
Inc. (the "Company"), hereby constitutes and appoints Tahir Mahmood, Shawn Cross
and Brandon Hants, and each of them, as the undersigned's true and lawful
attorney-in-fact to:
1. complete and execute Forms 3, 4 and 5 and other forms and all amendments
thereto as such attorney-in-fact shall in his discretion determine to be
required or advisable pursuant to Section 16 of the Securities Exchange Act of
1934 (as amended) and the rules and regulations promulgated thereunder, or any
successor laws and regulations, as a consequence of the undersigned's ownership,
acquisition or disposition of securities of the Company; and
2. do all acts necessary in order to file such forms with the SEC, any
securities exchange or national association, the Company and such other person
or agency as the attorneys-in-fact shall deem appropriate.
The undersigned hereby ratifies and confirms all that said attorneys-in-fact and
agents shall do or cause to be done by virtue hereof. The undersigned
acknowledges that the foregoing attorneys-in-fact, in serving in such capacity
at the request of the undersigned, are not assuming, nor is the Company
assuming, any of the undersigned's responsibilities to comply with Section 16 of
the Securities Exchange Act of 1934 (as amended).
This Power of Attorney shall remain in full force and effect until 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,
unless earlier revoked by the undersigned in a signed writing delivered to the
Company and the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 29th day of January, 2022.
Signature: /s/ John W. Smither
Print Name: John W. Smither