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*
Kowieski Mark

(Last) (First) (Middle)
C/O EVOKE PHARMA, INC.
420 STEVENS AVENUE, SUITE 230

(Street)
SOLANA BEACH CA 92075

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/22/2024
3. Issuer Name and Ticker or Trading Symbol
Evoke Pharma Inc [ EVOK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
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 5,000 I By IRA
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
Stock Option (Right to Buy) (1) 06/12/2032 Common Stock 16,000 2.09 D
Stock Option (Right to Buy) (2) 02/07/2033 Common Stock 7,500 4.01 D
Explanation of Responses:
1. The option shall vest at the rate of 1/48th of the original number of shares on each monthly anniversary of June 13, 2022, subject to the reporting person's continuous service to the issuer on each such vesting date.
2. The option shall vest at the rate of 1/48th of the original number of shares on each monthly anniversary of January 1, 2023, subject to the reporting person's continuous service to the issuer on each such vesting date.
/s/ Mark Kowieski 05/30/2024
** 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.
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