Statement of Changes in Beneficial Ownership (4)
November 12 2019 - 4:49PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Patel Gautam |
2. Issuer Name and Ticker or Trading Symbol
Amneal Pharmaceuticals, Inc.
[
AMRX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O CEPHEID CAPITAL, LLC, 277 W. 4TH STREET, UNIT 2 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/11/2019 |
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(Street)
NEW YORK, NY 10014
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Class A Common Stock | 11/11/2019 | | C | | 12887433 | A | $0 | 12887433 | I | See footnote (1) |
| Class B Common Stock | 11/11/2019 | | J(2) | | 12887433 | D | $0 | 17497336 | I | See footnote (1) |
| Class A Common Stock | | | | | | | | 6107 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code
(Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4) | 8. Price of Derivative Security
(Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Common Units | (3) | 11/11/2019 | | C | | | 12887433 | (3) | (3) | Class A Common Stock | 12887433.0 | $0 | 17497336 | I | See footnote (1) |
| Explanation of Responses: |
| (1) | By trusts which the reporting person may be deemed to control. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. |
| (2) | Reflects the cancellation for no consideration of Class B Common Stock in connection with the conversion of the Common Units into shares of Class A Common Stock. |
| (3) | The Common Units may be redeemed at any time for shares of the Issuer's Class A Common Stock on a 1-to-1 basis. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Patel Gautam
C/O CEPHEID CAPITAL, LLC
277 W. 4TH STREET, UNIT 2
NEW YORK, NY 10014 | X | X |
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Signatures
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| /s/ Brian P. Spitser, Attorney-in-Fact | | 11/12/2019 |
| **Signature of Reporting Person | Date |
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