0001570562-23-000094.txt : 20230815
0001570562-23-000094.hdr.sgml : 20230815
20230815163415
ACCESSION NUMBER: 0001570562-23-000094
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230811
FILED AS OF DATE: 20230815
DATE AS OF CHANGE: 20230815
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: 231175361
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
wk-form4_1692131636.xml
FORM 4
X0508
4
2023-08-11
0
0001570562
Evolus, Inc.
EOLS
0001730123
Malik Vikram
520 NEWPORT CENTER DR.
SUITE 1200
NEWPORT BEACH
CA
92660
1
0
0
0
0
Common Stock
2023-08-11
4
J
0
22998
0
A
100583
D
Common Stock
2023-08-15
4
P
0
174967
7.41
A
275550
D
Pro rata distribution from Alphaeon 1, LLC of which the reporting person is a non-managing member.
Represents the private transfer of shares of common stock of the issuer from Strathspey Crown Holdings Group, LLC ("SCH") to the reporting person, who elected to receive payment of certain outstanding fees from SCH in the form of shares of common stock of the issuer held by SCH rather than cash.
/s/ Jeffrey J. Plumer, as attorney-in-fact for Vikram Malik
2023-08-15