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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 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. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
APPLE ROBERT F C/O ANTARES PHARMA, INC. 100 PRINCETON SOUTH, SUITE 300 EWING, NJ 08628 |
Executive Vice President & COO |
Jennifer Evans Stacey as attorney-in-fact for Robert F. Apple | 03/12/2015 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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) | These shares withheld for tax purposes were not timely reported. |
(2) | On July 6, 2012, Mr. Apple received a performance stock unit award under the 2008 Equity Compensation Plan. The target number of shares under the award is 25,039 shares, and the award is contingent upon the Company's achieving certain performance goals over the three-year period beginning January 1, 2012 and ending December 31, 2014. The 12,519 shares reported here represent the number of shares vested on February 10, 2015 upon the Company's achievement of a performance goal. 12,520 shares of the award remain subject to performance goals and may be earned by Mr. Apple pursuant to the terms of the award. Until earned, they have been removed from the amount of securities beneficially owned. |
(3) | Includes 32,362 shares of restricted common stock granted to Mr. Apple on 05/29/2014 and reported on a Form 4 dated 06/02/2014. The original Form 4 filed on 02/12/2015 did not include these 32,362 shares of restricted common stock. |