SEC FORM
4
SEC Form 4
| FORM 4 |
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
or Section 30(h) of the Investment Company Act of 1940
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| OMB Number: |
3235-0287 |
| Estimated average burden |
| hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
| C/O AQUESTIVE THERAPEUTICS, INC |
| 30 TECHNOLOGY DRIVE |
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Aquestive Therapeutics, Inc.
[ AQST ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
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10% Owner |
|
Officer (give title below) |
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Other (specify below) |
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|
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3. Date of Earliest Transaction
(Month/Day/Year)
08/16/2022
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|---|
| 1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction 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 |
V |
Amount |
(A) or (D) |
Price |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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|---|
| 1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction 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
(Month/Day/Year) |
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: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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| Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Non-Qualified Stock Option (right to buy) |
$1.5
|
08/16/2022 |
|
A |
|
28,500 |
|
|
08/16/2032 |
Common Stock |
28,500 |
$0
|
28,500 |
D |
|
| Explanation of Responses: |
|
| Remarks: |
|
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/s/ Lori Braender, as Attorney-In-Fact |
08/17/2022 |
|
** 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
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). |
| 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 constitutes
and appoints each of Lori J. Braender, A. Ernest Toth, Jr., Valerie Borchevsky
and Ellen S.
Knarr, signing singly, the undersigned's true and lawful attorney-in-fact to:
(i) execute for and on
behalf of the undersigned, in the undersigned's capacity as a director of
Aquestive Therapeutics,
Inc. (the "Company"), a Form ID, including updates thereto, and Forms 3, 4, and
5 in accordance
with Section 16(a) of the Securities Exchange Act of 1934 and the rules
thereunder; (ii) do and
perform any and all acts for and on behalf of the undersigned which may be
necessary or
desirable to complete and execute any such Form ID, including updates thereto,
or Form 3, 4, or
5 and timely file such form with the United States Securities and Exchange
Commission and any
stock exchange or similar authority; and (iii) take any other action of any type
whatsoever in
connection with the foregoing which, in the opinion of such attorney-in-fact,
may be of benefit
to, in the best interest of, or legally required by, the undersigned, it being
understood that the
documents executed by such attorney-in-fact on behalf of the undersigned
pursuant to this Power
of Attorney shall be in such form and shall contain such terms and conditions as
such attorney-in-fact may approve in such attorney-in-fact's discretion.
The undersigned hereby grants to each 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's
substitute or substitutes, 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
attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are 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 attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be executed as of this 12 day of August, 2022.
Timothy E. Morris
