| 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/08/2022 |
3. Issuer Name and Ticker or Trading Symbol
Applied Therapeutics Inc. [ APLT ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
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| 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 | 12,323(1) | D | |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 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 | ||||
| Employee Stock Option (right to buy) | (2) | 09/13/2031 | Common Stock | 19,707(2) | 14.2 | D | |
| Explanation of Responses: |
| 1. Includes 9,242 unvested compensatory Restricted Stock Units. |
| 2. Consists of compensatory Options. One-fourth (1/4th) of the shares subject to the compensatory Option vested on February 1, 2022, and one thirty-sixth (1/36th) of the remaining shares subject to the compensatory Option shall vest each month thereafter, subject to the Reporting Person continuing to provide services through each such date. |
| Remarks: |
| Exhibit List - Exhibit 24 - Power of Attorney |
| /s/ Shoshana Shendelman as attorney-in-fact | 03/18/2022 | |
| ** 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 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. | ||
Exhibit 24
POWER OF ATTORNEY
(For Executing Form ID and Forms 3, 4 and 5)
Know all by these presents, that the
undersigned hereby constitutes and appoints each of Shoshana Shendelman and
Chids Mahadevan
of Applied Therapeutics, Inc. (the "Company") and Michael Schwartz,
Alicja Lam and Julie Li of Skadden, Arps, Slate, Meagher & Flom LLP, signing
individually, the undersigned's true and lawful attorneys-in-fact and agents
to:
(1) Prepare,
execute in the undersigned's name and on the undersigned's behalf, and
submit to the Securities and Exchange Commission (the "SEC"), a Form ID and
Forms 3, 4 and 5 (including amendments thereto and joint filing agreements in
connection therewith)
in accordance with Section 16 of the Securities Exchange Act of 1934, as
amended (the "Exchange Act"), and the rules thereunder, in the undersigned's
capacity as an officer, director or beneficial owner of more than 10% of a
registered class of
securities of the Company;
(2) Do and
perform any and all acts for and on behalf of the undersigned that may
be necessary or desirable to prepare and execute any such Form ID and Forms 3, 4
or 5 (including amendments thereto and joint filing agreements in connection
therewith) and file
such forms with the SEC and any stock exchange, self-regulatory
association or any similar authority; and
(3) Take any
other action of any type whatsoever in connection with the foregoing
that, in the opinion of such attorney-in-fact, may be of benefit to, in the best
interest of, or legally required of the undersigned, it being understood that
the documents
executed by the 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 the attorney-in-fact may approve in the 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, or 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, and their
substitutes, 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 Exchange Act.
This Power of Attorney shall remain in full
force and effect until the earliest to occur of (a) 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, (b) revocation
by the undersigned in a signed writing delivered to the Company and the
foregoing attorneys-in fact
or (c) as to any attorney-in-fact individually, until such
attorney-in-fact is no longer employed by the Company or employed by or a
partner at Skadden, Arps, Slate, Meagher & Flom LLP or another law firm
representing the Company, as applicable.
IN WITNESS WHEREOF, the undersigned has caused
this Power of Attorney to be executed as of the date written below.
Date: March 8, 2022
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/s/ Steven A. Ortega
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Steven A. Ortega
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