Sec Form 4 Filing - MacDougall Ann L. @ OPIANT PHARMACEUTICALS, INC. - 2021-05-13

Insider filing report for Changes in Beneficial Ownership
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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
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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1. Name and Address of Reporting Person
MacDougall Ann L.
2. Issuer Name and Ticker or Trading Symbol
OPIANT PHARMACEUTICALS, INC. [ OPNT]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O OPIANT PHARMACEUTICALS, INC., 233 WILSHIRE BLVD., SUITE 280
3. Date of Earliest Transaction (MM/DD/YY)
05/13/2021
(Street)
SANTA MONICA, CA90401
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 05/13/2021 M 341 A $ 10 21,179 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) $ 10 05/13/2021 M 341 ( 1 ) 05/16/2021 Common Stock 341 $ 10 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
MacDougall Ann L.
C/O OPIANT PHARMACEUTICALS, INC.
233 WILSHIRE BLVD., SUITE 280
SANTA MONICA, CA90401
X
Signatures
/s/ Ann L. MacDougall 05/13/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )On May 17, 2016, the reporting person was granted an option to purchase 35,000 shares of Common Stock. The options vest as follows: (i) 11,667 share upon the up listing of the Issuer to The NASDAQ Stock Market (which occurred on August 29, 2017); (ii) 11,667 shares upon the cumulative funding of the Issuer in excess of $5,000,000 by institutional investors, commencing May 5, 2016 (which performance criteria was met on December 13, 2016); and (iii) 11,666 shares upon the first submission of a New Drug Application ("NDA") to the FDA for one of Issuer's products by either the Issuer or an Issuer licensee.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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