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
 
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1. Name and Address of Reporting Person*
GRAMMER ELIZABETH A

(Last) (First) (Middle)
34175 ARDENWOOD BLVD., SUITE 100

(Street)
FREMONT CA 94555

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/18/2014
3. Issuer Name and Ticker or Trading Symbol
ARDELYX, INC. [ ARDX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP and General Counsel
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 5,000(1) 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
Stock Options (Right to buy) (2) 10/26/2020 Common Stock 5,000(1) 1.08(1) D
Stock Options (Right to buy) (2) 04/15/2021 Common Stock 5,000(1) 1.08(1) D
Stock Options (Right to buy) (2) 08/11/2021 Common Stock 5,000(1) 0.54(1) D
Stock Options (Right to buy) (2) 11/12/2022 Common Stock 5,000(1) 3.42(1) D
Stock Options (Right to buy) (3) 12/06/2022 Common Stock 72,222(1) 3.42(1) D
Explanation of Responses:
1. Reflects a one-for-nine reverse split of the Issuer's stock effected immediately prior to the consummation of the Issuer's initial public offering.
2. The option is fully vested and exercisable.
3. The option is immediately exercisable in full, but the shares subject thereto vest according to the following schedule: Twenty-five percent (25%) of the shares subject to the option vest on the first anniversary measured from December 1, 2012, and the remaining shares subject to the option vest in 36 successive, equal monthly installments thereafter, subject to the Reporting Person's continued employment or service relationship with the Issuer on each such vesting date.
Remarks:
/s/ Elizabeth Grammer 06/18/2014
** 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.
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