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*
C/O ACADIA PHARMACEUTICALS INC. |
3611 VALLEY CENTRE DRIVE, SUITE 300 |
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 11/02/2018
|
3. Issuer Name and Ticker or Trading Symbol
ACADIA PHARMACEUTICALS INC
[ ACAD ]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
X |
Officer (give title below) |
|
Other (specify below) |
Controller & PAO |
|
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 |
3,212 |
D |
|
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 |
Employee Stock Option (Right to Buy) |
|
05/29/2024 |
Common Stock |
7,500 |
20.65 |
D |
|
Employee Stock Option (Right to Buy) |
|
01/25/2025 |
Common Stock |
3,900 |
32.28 |
D |
|
Employee Stock Option (Right to Buy) |
|
01/05/2026 |
Common Stock |
6,615 |
29.24 |
D |
|
Employee Stock Option (Right to Buy) |
|
03/07/2027 |
Common Stock |
7,350 |
36.54 |
D |
|
Employee Stock Option (Right to Buy) |
|
09/06/2027 |
Common Stock |
9,187 |
35.8 |
D |
|
Employee Stock Option (Right to Buy) |
|
04/06/2028 |
Common Stock |
5,570 |
16.5 |
D |
|
Employee Stock Option (Right to Buy) |
|
10/14/2028 |
Common Stock |
3,342 |
21.28 |
D |
|
Restricted Stock Units |
|
|
Common Stock |
1,671 |
|
D |
|
Explanation of Responses: |
Remarks: |
|
/s/ Eric Alejandro Miller |
11/09/2018 |
|
** 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. |
POWER OF ATTORNEY
Know all by these presents, that the undersigned hereby authorizes Austin D.
Kim, Reena Desai or Martin Choy to execute for and on behalf of the undersigned,
in the undersigned's capacity as an officer of ACADIA Pharmaceuticals Inc. (the
"Company"), Forms 3, 4 and 5 and any Amendments thereto, and cause such form(s)
to be filed with the Securities and Exchange Commission pursuant to Section
16(a) of the Securities Exchange Act of 1934, relating to the undersigned's
beneficial ownership of securities in the Company. The undersigned hereby
grants to such attorney-in-fact full power and authority to do and perform any
and every act and thing whatsoever requisite, necessary, or proper to be done in
the exercise of any of the rights and powers herein granted, as fully to all
intents and purposes as the undersigned might or could do if personally present,
with full power of substitution or revocation, hereby ratifying and confirming
all that such attorney-in-fact, or substitute or substitutes of such
attorney-in-fact, shall lawfully do or cause to be done by virtue of this power
of attorney and the rights and powers herein granted. The undersigned
acknowledges that the foregoing attorney-in-fact, in serving in such capacity at
the request of the undersigned, is not assuming, nor is the Company assuming,
any of the undersigned's responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of, and transactions in, securities issued by the
Company, unless earlier revoked by the undersigned in a signed writing delivered
to the foregoing attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed this 9th day of November 2018.
/s/ Eric Miller