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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| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
| C/O AASTROM BIOSCIENCES, INC. |
| P.O. BOX 376 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
08/23/2013
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3. Issuer Name and Ticker or Trading Symbol
AASTROM BIOSCIENCES INC
[ ASTM ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
| X |
Officer (give title below) |
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Other (specify below) |
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Controller
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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)
| X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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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)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Stock Option (right to buy) |
|
12/20/2021 |
Common Stock |
100,000 |
1.86 |
D |
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| Stock Option (right to buy) |
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05/03/2022 |
Common Stock |
50,000 |
2.49 |
D |
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| Explanation of Responses: |
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/s/ Dominick C. Colangelo, attorney-in-fact |
08/27/2013 |
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** 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. |
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned's hereby
makes, constitutes and appoints each of Dominick Colangelo and
Mitchell S. Bloom as the undersigned's true and lawful attorney-
in-fact, with full power and authority as hereinafter described
on behalf of and in the name, place and stead of the undersigned
to:
(1) prepare, execute, acknowledge, deliver and file Forms 3, 4,
and 5 (including any amendments thereto) with respect to the
securities of Aastrom Biosciences, Inc., a Michigan corporation
(the "Company"), with the United States Securities and Exchange
Commission, any national securities exchanges and the Company, as
considered necessary or advisable under Section 16(a) of the
Securities Exchange Act of 1934 and the rules and regulations
promulgated thereunder, as amended from time to time (the
"Exchange Act");
(2) seek or obtain, as the undersigned's representative and on
the undersigned's behalf, information on transactions in the
Company's securities from any third party, including brokers,
employee benefit plan administrators and trustees, and the
undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and ratifies any such
release of information; and
(3) perform any and all other acts which in the discretion of
such attorney-in-fact are necessary or desirable for and on
behalf of the undersigned in connection with the foregoing.
The undersigned acknowledges that:
(1) this Power of Attorney authorizes, but does not require, such
attorney-in-fact to act in his or her discretion on information
provided to such attorney-in-fact without independent
verification of such information;
(2) any documents prepared and/or executed by such attorney-in-
fact on behalf of the undersigned pursuant to this Power of
Attorney will be in such form and will contain such information
and disclosure as such attorney-in-fact, in his or her
discretion, deems necessary or desirable;
(3) neither the Company nor such attorney-in-fact assumes (i) any
liability for the undersigned's responsibility to comply with the
requirement of the Exchange Act, (ii) any liability of the
undersigned for any failure to comply with such requirements, or
(iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act; and
(4) this Power of Attorney does not relieve the undersigned from
responsibility for compliance with the undersigned's obligations
under the Exchange Act, including without limitation the
reporting requirements under Section 16 of the Exchange Act.
The undersigned hereby gives and grants the foregoing
attorney-in-fact full power and authority to do and perform all
and every act and thing whatsoever requisite, necessary or
appropriate to be done in and about the foregoing matters as
fully to all intents and purposes as the undersigned might or
could do if 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.
This Power of Attorney shall remain in full force and effect
until revoked by the undersigned in a signed writing delivered to
such attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this
Power of Attorney to be executed as of this 24th day of August,
2013.
/s/ Michael W. Elliston
________________________________
Signature
Michael W. Elliston
_________________________________
Print Name
