UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Employee Stock Option to Acquire Common Stock | Â (1) | 03/01/2022 | Common Stock | 27,313 | $ 4.29 | D | Â |
Employee Stock Option to Acquire Common Stock | Â (2) | 01/15/2023 | Common Stock | 131,687 | $ 5.88 | D | Â |
Employee Stock Option to Acquire Common Stock | Â (3) | 06/05/2025 | Common Stock | 9,095 | $ 39.26 | D | Â |
Employee Stock Option to Acquire Common Stock | Â (4) | 10/30/2025 | Common Stock | 75,000 | $ 28.11 | D | Â |
Employee Stock Option to Acquire Common Stock | Â (5) | 03/21/2026 | Common Stock | 12,467 | $ 25.92 | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Rice Gary C/O DIPLOMAT PHARMACY, INC. 4100 SOUTH SAGINAW STREET FLINT, MI 48507 |
 |  |  EVP of Operations |  |
Jeffrey H. Kuras, by Power of Attorney | 12/09/2016 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The options were granted on March 1, 2012 and are fully vested. |
(2) | The options were granted on January 15, 2013. The options began to vest in annual increments of 25% of the option grant on the one-year anniversary of the grant date, to be fully vested after four years. 75% of the options originally granted are currently vested and exercisable. |
(3) | The options were granted on June 5, 2015. The options began to vest 25% upon determination in March 2016 of the achievement of certain performance criteria and will continue to vest in annual increments of 25% thereafter. 25% of the options originally granted are currently vested and exercisable. |
(4) | The options were granted on October 30, 2015. The options began to vest in annual increments of 25% of the option grant on the one-year anniversary of the grant date, to be fully vested after four years. 25% of the options originally granted are currently vested and exercisable. |
(5) | The options were granted on March 21, 2016, and vest according to certain financial performance criteria of the Company. To the extent such criteria are met, 25% will vest on approximately March 31, 2017, and the remaining options will continue to vest in annual increments of 25% thereafter. |
 Remarks: Exhibit 24, Power of Attorney, is attached. |