Amended Statement of Changes in Beneficial Ownership (4/a)
04 Setembro 2013 - 3:00PM
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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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
*
Shell William
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2. Issuer Name
and
Ticker or Trading Symbol
Targeted Medical Pharma, Inc.
[
TRGM
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
CEO & Chief Scientific Officer
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(Last)
(First)
(Middle)
C/O TARGETED MEDICAL PHARMA, INC., 2980 BEVERLY GLEN CIRCLE, SUITE 301
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3. Date of Earliest Transaction
(MM/DD/YYYY)
4/16/2013
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(Street)
LOS ANGELES, CA 90077
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
7/23/2013
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
_
X
_ 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, $.001 par value per share
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6/20/2013
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P
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28100
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A
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$1.15
(2)
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651054
(2)
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I
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By trust
(1)
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Common Stock, $.001 par value per share
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622954
(3)
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I
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By trust
(1)
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(
1)
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Common stock and warrants are held by Willliam Shell Survivor's Trust.
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(
2)
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On July 23, 2013, the reporting person mistakenly filed a Form 4 without including his purchase of 28,100 shares of Targeted Medical Pharma, Inc. Such purchase occurred on June 20, 2013 at a weighted average price of $1.15 per share. These shares were purchased in multiple transactions at prices ranging from $1.00 to $1.20 per share.
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(
3)
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See Remarks
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Remarks:
On July 23, 2013, the reporting person mistakenly filed a Form 4 reporting the purchase of certain shares of Targeted Medical Pharma, Inc. even though such purchases were cancelled prior to delivery. Below is a summary of the purchases that were mistakenly filed on the Form 4:
- 1,500 shares at a price of $4.25 per share on April 23, 2013
- 2,500 shares in multiple transactions at prices ranging from $4.25 to $4.30 per share on April 22, 2013
- 1,000 shares at a price of $4.35 per share on April 19, 2013
- 6,000 shares in multiple transactions at prices ranging from $4.55 to $4.79 per share on April 17, 2013
- 6,000 shares in multiple transactions at prices ranging from $4.38 to $4.90 per share on April 16, 2013
As a result of these canceled purchases, the reporting person beneficially owns 622,954 shares of Targeted Medical Pharma, Inc.'s common stock as opposed to the previously reported amount of shares (639,954 shares).
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Shell William
C/O TARGETED MEDICAL PHARMA, INC.
2980 BEVERLY GLEN CIRCLE, SUITE 301
LOS ANGELES, CA 90077
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X
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X
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CEO & Chief Scientific Officer
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Elizabeth Charuvastra & William Shell Family Trust
3048 NICADA DRIVE
LOS ANGELES, CA 90077
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X
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Signatures
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/s/ William E. Shell
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9/4/2013
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**
Signature of Reporting Person
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Date
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Elizabeth Charuvastra and William Shell Family Trust dated 9/26/2008,by /s/ William E. Shell, Trustee
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9/4/2013
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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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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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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