SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL 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
 
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Braun Samuel J

(Last) (First) (Middle)
5 WEST MAIN STREET
BOX 361

(Street)
WARNER SD 57479-0361

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/10/2021
3. Issuer Name and Ticker or Trading Symbol
KEMPHARM, INC [ KMPH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
COMMON STOCK 3,060,000 D(1)
COMMON STOCK 68,000 I By Thinkswitch Capitol, LLC(2)
COMMON STOCK 15,000 I By ThetaBurn Investments, LLC(2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
CALL OPTION (OBLIGATION TO BUY) 08/20/2021 08/20/2021 COMMON STOCK 2,000 (3) D
Explanation of Responses:
1. Includes 60,000 shares held in a jointly-owned account over which the reporting person exercises sole investment discretion. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
2. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
3. The Call Options represent the reporting person's obligation to purchase the referenced shares if the trading price on the expiration date exceeds $10 per share. Otherwise, exercise of the options is at the holder's discretion.
/s/ Samuel J. Braun 05/17/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.