Statement of Changes in Beneficial Ownership (4)
01 April 2020 - 10:12PM
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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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
*
Lynch Thomas G |
2. Issuer Name and Ticker or Trading Symbol
Evofem Biosciences, Inc.
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EVFM
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O EVOFEM BIOSCIENCES, INC., 12400 HIGH BLUFF DRIVE, SUITE 600 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/31/2020 |
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(Street)
SAN DIEGO, CA 92130
(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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| Common Stock | 3/31/2020 | | M | | 37500 | A(1) | $0 | 325000 | 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 |
| Restricted Stock Units | (1) | 3/31/2020 | | M | | 37500 | | (2) | (2) | Common Stock | 37500.0 | $0 | 0 | D | |
| Restricted Stock Units | (1) | 4/1/2020 | | A | | 150000 | | (3) | (3) | Common Stock | 150000.0 | $0 | 150000 | D | |
| Explanation of Responses: |
| (1) | Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. The restricted stock units were granted in consideration for certain consulting services to be provided to the Issuer in connection with the consulting agreement between Mr. Lynch and the Issuer effective April 1, 2019. |
| (2) | The restricted stock units shall vest in four equal installments on June 30, 2019, September 30, 2019, December 31, 2019 and March 31, 2020. |
| (3) | The restricted stock units shall vest in four equal installments on June 30, 2020, September 30, 2020, December 31, 2020 and March 31, 2021. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Lynch Thomas G
C/O EVOFEM BIOSCIENCES, INC.
12400 HIGH BLUFF DRIVE, SUITE 600
SAN DIEGO, CA 92130 | X |
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Signatures
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| /s/ Justin J. File, attorney-in-fact | | 4/1/2020 |
| **Signature of Reporting Person | Date |
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