Edgar Filing: Pruzanski Mark

Ownership Submission

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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

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(Print or Type Responses)

1. Name and Address of Reporting Person ^*

Â Pruzanski Mark

2. Date of Event Requiring Statement (Month/Day/Year)
10/10/2012

3. Issuer Name and Ticker or Trading Symbol
INTERCEPT PHARMACEUTICALS INC [ICPT]

(Last)

(First)

(Middle)

C/O INTERCEPT PHARMACEUTICALS, INC.,Â 18 DESBROSSES ST.

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

__X__ Director	_____ 10% Owner
__X__ Officer (give title below)	_____ Other (specify below)
President and CEO

5. If Amendment, Date Original Filed(Month/Day/Year)

(Street)

NEW YORK,Â NYÂ 10013

6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

(City)

(State)

(Zip)

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	380,767 ⁽¹⁾	D	Â

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.			SEC 1473 (7-02)
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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 of Derivative Security: 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		6. Nature of Indirect Beneficial Ownership (Instr. 5)
Options to Purchase Common Stock	Â ⁽²⁾	06/30/2014	Common Stock	8,653 ⁽³⁾	$ 2.89 ⁽³⁾	D	Â
Options to Purchase Common Stock	Â ⁽²⁾	01/01/2015	Common Stock	25,961 ⁽³⁾	$ 2.89 ⁽³⁾	D	Â
Options to Purchase Common Stock	Â ⁽²⁾	07/18/2016	Common Stock	64,903 ⁽³⁾	$ 9.82 ⁽³⁾	D	Â
Options to Purchase Common Stock	Â ⁽²⁾	07/18/2016	Common Stock	64,903 ⁽³⁾	$ 9.82 ⁽³⁾	D	Â
Options to Purchase Common Stock	Â ⁽²⁾	09/18/2018	Common Stock	41,105 ⁽³⁾	$ 9.82 ⁽³⁾	D	Â
Options to Purchase Common Stock	Â ⁽⁴⁾	07/20/2020	Common Stock	250,960 ⁽³⁾	$ 8.67 ⁽³⁾	D	Â
Options to Purchase Common Stock	Â ⁽⁵⁾	10/13/2021	Common Stock	45,865 ⁽³⁾	$ 8.67 ⁽³⁾	D	Â

Reporting Owners

Reporting Owner Name / Address	Relationships
Reporting Owner Name / Address	Director	10% Owner	Officer	Other
Pruzanski Mark C/O INTERCEPT PHARMACEUTICALS, INC. 18 DESBROSSES ST. NEW YORK,Â NYÂ 10013	Â X	Â	Â President and CEO	Â

Signatures

/s/ Barbara Duncan, as Attorney-in-fact		10/10/2012
^**Signature of Reporting Person		Date

Explanation of Responses:

*	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).
(1)	Reflects a 1-for-5.7778 reverse stock split effected on September 26, 2012.
(2)	All of the shares underlying this option have vested.
(3)	Reflects the 1-for-5.7778 reverse stock split effected on September 26, 2012 in connection with the Issuer's initial public offering, pursuant to which (i) the number of shares of common stock underlying the option was divided by 5.7778 and (ii) the exercise price of the option was multiplied by 5.7778.
(4)	25% of the shares underlying this option were vested on December 31, 2010, and the remainder of the shares originally underlying the option vest on a pro rata monthly basis through December 31, 2013, subject to the terms and conditions thereof.
(5)	19.59% of the shares underlying this option were vested on October 13, 2011, the date of grant, and the remainder of the shares originally underlying the option vest on a pro rata monthly basis through December 31, 2014, subject to the terms and conditions thereof.
Â Remarks: ExhibitÂ ListÂ -Â ExhibitÂ 24Â -Â PowerÂ ofÂ Attorney

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