SEC FORM 3/A 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*
Schupp Joachim PH

(Last) (First) (Middle)
C/O IMPRIMIS PHARMACEUTICALS, INC.
437 SOUTH HIGHWAY 101, SUITE 209

(Street)
SOLANA BEACH CA 92075

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/25/2012
3. Issuer Name and Ticker or Trading Symbol
Imprimis Pharmaceuticals, Inc. [ IMMY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Medical Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
03/27/2012
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)
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
Option (Right to Buy) 12/15/2011(1) 12/14/2014 Common Stock 2,464 0.8 D
Option (Right to Buy) 02/28/2012(2) 02/14/2016 Common Stock 375,000 0.72(3) D
Explanation of Responses:
1. The stock options, granted on December 15, 2011 with a strike price of $.80 and exercisable immediately upon issuance, were granted pursuant to the Issuer's 2007 Stock Incentive and Awards Plan.
2. The stock options, granted on February 15, 2012 and effective as of February 28, 2012, were granted pursuant to the Issuer's 2007 Stock Incentive and Awards Plan. Dr. Schupp's options vest over a 3 year period at a strike price of $0.72, with 1/36 of the total number of options vesting each monthly period following the grant date of such options. As of the date of this Form 3 filing, options to purchase 41,668 shares of the Issuer's common stock are exercisable, but no options have been exercised.
3. This amended Form 3 is being filed by Dr. Schupp to amend his original Form 3 filed on March 27, 2012, for the sole purpose of correcting the exercise price of the stock options granted to Dr. Schupp on February 15, 2012 as described in Footnote 2 above from $0.60 to $0.72.
Joachim Schupp 05/09/2012
** 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.