UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock options | (1) | (1) | Common stock | 21,000 | $ 0.001 | D | |
Stock options | (2) | (2) | Common stock | 23,520 | $ 0.001 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Tsuchimoto Kim R C/O MONOPAR THERAPEUTICS INC. 1000 SKOKIE BLVD., SUITE 350 WILMETTE, IL 60091 |
Chief Financial Officer |
/s/ Kim R. Tsuchimoto | 01/08/2018 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Reflects the issuance of options to purchase up to 21,000 shares of common stock granted to Ms. Tsuchimoto on April 4, 2016 for her services as an officer of Monopar Therapeutics. The options vested 50% upon grant date, 25% upon the 6-month anniversary of grant date, and 25% upon the 1-year anniversary of grant date. The options each expire on April 3, 2026. |
(2) | Reflects the issuance of options to purchase up to 23,520 shares of common stock granted to Ms. Tsuchimoto on February 20, 2017 for her services as an officer of Monopar Therapeutics. The options vest 6/48ths on the six-month anniversary of the grant date and 1/48th on each subsequent one-month anniversary thereafter. The options each expire on February 19, 2027. |