SEC Filing | Aptevo Therapeutics Inc

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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^*

Gross Jane A

(Last)

(First)

(Middle)

2401 4TH AVENUE, SUITE 1050

(Street)

SEATTLE

98121

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
09/01/2016

3. Issuer Name and Ticker or Trading Symbol
Aptevo Therapeutics Inc. [ APVO ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
See Remarks

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	3,658⁽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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Stock Option (right to buy)⁽¹⁾	03/10/2017	03/10/2021	Common Stock	29,010	2.47	D
Restricted Stock Units⁽¹⁾	03/10/2017	03/10/2021	Common Stock	14,506	⁽²⁾	D
Stock Option (right to buy)⁽¹⁾	⁽³⁾	03/09/2022	Common Stock	38,908	2.55	D
Restricted Stock Units⁽¹⁾	⁽⁴⁾	03/09/2022	Common Stock	19,455	⁽²⁾	D
Stock Option (right to buy)⁽¹⁾	⁽⁵⁾	02/28/2026	Common Stock	54,721	2.97	D
Restricted Stock Units⁽¹⁾	⁽⁶⁾	02/28/2026	Common Stock	27,418	⁽²⁾	D
Restricted Stock Units	08/01/2017	08/03/2026	Common Stock	38,093	⁽²⁾	D
Restricted Stock Units	⁽⁷⁾	02/10/2018	Common Stock	36,271	⁽²⁾	D

Explanation of Responses:

1. Each security was originally issued by Emergent BioSolutions, Inc. and, as a result of the spin-off of the Issuer from Emergent BioSolutions, Inc. effective on August 1, 2016, was adjusted and assumed by the Issuer.

2. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock.

3. The stock options were granted on March 10, 2015 and vest in two equal installments on March 9, 2017 and March 9, 2018.

4. The restricted stock units were granted on March 10, 2015 and vest as follows: 9,727 on March 9, 2017 and 9,728 on March 9, 2018.

5. The stock options were granted on March 1, 2016 and vest as follows: 18,241 on March 1, 2017, 18,241 on March 1, 2018 and 18,239 on March 1, 2019.

6. The restricted stock units were granted on March 1, 2016 and vest as follows: 9,140 on March 1, 2017, 9,140 on March 1, 2018 and 9,138 on March 1, 2019.

7. The restricted stock units were granted on August 3, 2016 and vest as follows: 18,135 on February 3, 2017, and 18,136 on February 3, 2018.

Remarks:

Title - SVP, Research and Non-Clinical Development. Exhibit List: Exhibit 24 - Power of Attorney.

	/s/ Benjamin J. Stein, attorney-in-fact	09/12/2016
	** 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 constitutes and appoints each of Carl A. Valenstein, Rani Doyle and Benjamin J. Stein, as his or her true and lawful attorney-in-fact to:

(1) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer or director of Aptevo Therapeutics Inc., Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder, and any other forms or reports the undersigned may be required to file in connection with the undersigned's ownership, acquisition, or disposition of securities of the Company;

(2) 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 3, 4, or 5, or other form or report, and timely file such form or report with the U.S. Securities and Exchange Commission and any stock exchange or similar authority; and

(3) 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 his or her discretion.

The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform each and every act and thing whatsoever requisite, necessary, and 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 his or her 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 no such attorney-in-fact, in serving in such capacity at the request of the undersigned, is hereby assuming any of the undersigned's responsibilities to comply with Section 13 and Section 16 of the Securities Exchange Act of 1934 and the rules thereunder, as amended.

This Power of Attorney shall remain in full force and effect until revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.

[Signature Page Follows]

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 7th day of September, 2016.

/s/ Jane Gross

Jane Gross

[Signature Page to Power of Attorney]