0001570562-20-000036.txt : 20200124
0001570562-20-000036.hdr.sgml : 20200124
20200124210709
ACCESSION NUMBER: 0001570562-20-000036
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200123
FILED AS OF DATE: 20200124
DATE AS OF CHANGE: 20200124
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Malik Vikram
CENTRAL INDEX KEY: 0001730123
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38381
FILM NUMBER: 20546933
MAIL ADDRESS:
STREET 1: 17901 VON KARMAN AVENUE, SUITE 150
CITY: IRVINE
STATE: CA
ZIP: 92614
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_157991801048284.xml
FORM 4
X0306
4
2020-01-23
0
0001570562
Evolus, Inc.
EOLS
0001730123
Malik Vikram
520 NEWPORT CENTER DR.
SUITE 1200
NEWPORT BEACH
CA
92660
1
0
0
0
Stock Option (Right to Buy)
10.19
2020-01-23
4
A
0
23458
0
A
2030-01-23
Common Stock
23458.0
23458
D
The shares subject to the option will vest as to 1/12 of the underlying shares monthly from the vesting commencement date of January 23, 2020, 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.
/s/ Jeffrey J. Plumer, as attorney-in-fact for Vikram Malik
2020-01-24