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*
Brar Balbir

(Last) (First) (Middle)
IMPRIMIS PHARMACEUTICALS, INC.
437 S HWY 101, STE 209

(Street)
SOLANA BEACH CA 92075

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/23/2012
3. Issuer Name and Ticker or Trading Symbol
Imprimis Pharmaceuticals, Inc. [ IMMY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
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 16,717 D
Common Stock 49,305 I Balbir S Brar TTY Trust(1)
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) 02/28/2012(2) 01/22/2016 Common Stock 1,125,000 0.74 D
Option (Right to Buy) 04/01/2012(3) 03/31/2017 Common Stock 125,000 0.9 D
Explanation of Responses:
1. Mr. Balbir Brar is the trustee of the Balbir S Brar TTY Trust and may be deemed to have voting and dispositive power the 49,305 shares of Common Stock owned by the Balbir S Brar TTY Trust. Mr. Brar disclaim beneficial ownership over such shares.
2. The stock options, granted on January 23, 2012 and effective as of February 28, 2012, were granted pursuant to the Issuer's 2007 Stock Incentive and Awards Plan. Mr. Brar's options vest over a 4 year period at a strike price of $0.74, with 1/36 of the total number of options vesting each monthly period following the grant date of the issuance of such options. As of the date of this Form 3 filing, options to purchase 156,250 shares of the Issuer's common stock are exercisable, but no options have been exercised.
3. The stock options, granted on April 1, 2012, were granted pursuant to the Issuer's 2007 Stock Incentive and Awards Plan. Mr. Brar's options maintain a strike price of $0.90, and vest quarterly over a one year term with the initial 31,250 options vesting on June 30, 2012, the next 31,250 options vesting on September 30, 2012, the next 31,250 options vesting on December 31, 2012 and the final 31,250 options vesting on March 31, 2013.
Balbir Brar 04/27/2012
** 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).
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