Sec Form 4 Filing - Medytox Inc. @ Evolus, Inc. - 2021-08-12

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
Medytox Inc.
2. Issuer Name and Ticker or Trading Symbol
Evolus, Inc. [ EOLS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
78, GANGNI 1-GIL, OCHANG-EUP,, CHEONGWON-GU
3. Date of Earliest Transaction (MM/DD/YY)
08/12/2021
(Street)
CHEOGIU-SI, M528126
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, $0.00001 par value per share 08/12/2021( 1 ) P 23,000 A $ 10.9902 ( 2 ) 7,282,500 I See Footnote ( 4 )
Common Stock, $0.00001 par value per share 08/13/2021( 1 ) P 14,043 A $ 11.1133 ( 3 ) 7,296,543 I See Footnote ( 4 )
Common Stock, $0.00001 par value per share 01/20/2023( 1 ) S 37,043 D $ 11.04 7,259,500 I See Footnote ( 4 )
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 Indi rect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Medytox Inc.
78, GANGNI 1-GIL, OCHANG-EUP,
CHEONGWON-GU
CHEOGIU-SI, M528126
X
Signatures
/s/ Minjung Choi, Senior Manager, on behalf of Medytox Inc. 02/06/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Inadvertently filed late due to an administrative error.
( 2 )The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $10.88 to $11.10, inclusive. The reporting person undertakes to provide to Evolus, Inc. (the "Issuer"), any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the ranges set forth in footnotes 1 to 2.
( 3 )The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $10.91 to $11.26, inclusive.
( 4 )The Issuer shares were previously held of record by Medytox Korea Co., Ltd. ("Medytox Korea"). Medytox, Inc. owns 100% of Medytox Korea. Accordingly, Medytox, Inc. may be deemed to beneficially own indirectly the shares by reason of Medytox Korea's direct beneficial ownership.

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 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).

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