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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 09/13/2021
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3. Issuer Name and Ticker or Trading Symbol
AMGEN INC
[ AMGN ]
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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) |
SVP, Business Development |
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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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Common Stock |
4,068
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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)
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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 |
Nqso (Right to Buy) |
05/01/2019
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05/01/2027 |
Common Stock |
1,252 |
162.6 |
D |
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Nqso (Right to Buy) |
04/27/2020
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04/27/2028 |
Common Stock |
1,518 |
177.46 |
D |
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Nqso (Right to Buy) |
05/03/2021
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05/03/2029 |
Common Stock |
3,642 |
177.31 |
D |
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Nqso (Right to Buy) |
05/05/2022
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05/05/2030 |
Common Stock |
2,515 |
236.36 |
D |
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Nqso (Right to Buy) |
04/30/2023
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04/30/2031 |
Common Stock |
3,260 |
239.64 |
D |
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Explanation of Responses: |
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/s/ Rachna Khosla |
09/13/2021 |
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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. |
Exhibit 24
Power of Attorney
Know all men by these presents, that the undersigned hereby
constitutes and appoints each of Dennis Yai and Andrea A. Robinson,
signing singly, the undersigned's true and lawful attorney-in-fact to
execute for and on behalf of the undersigned Forms 3, 4 and 5 in
accordance with Section 16(a) of the Securities Exchange Act of 1934,
as amended, and the rules thereunder, as may be required as a result
of the undersigneds position as an officer and/or director of Amgen Inc.
(the "Company").
The undersigned hereby grants to each such attorney-in-fact
full power and authority to execute such Forms 3, 4 and 5 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, 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 Securities Exchange Act
of 1934, as amended.
This Power of Attorney shall remain in full force and
effect until the undersigned is no longer required to file Forms 3, 4
and 5 with respect to the undersigneds holdings of and transactions
in securities issued by the Company, unless earlier revoked by the
undersigned in a signed writing delivered to the foregoing attorneys-
in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power
of Attorney to be executed as of this 25th day of August, 2021.
/s/ Rachna Khosla
Name: Rachna Khosla