FORM 5
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN 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 *
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Cleary James F |
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2. Issuer Name and Ticker or Trading Symbol AMERISOURCEBERGEN CORP [ABC]
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5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
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_____ 10% Owner
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__X__ Officer (give title below)
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_____ Other (specify below)
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Chief Financial Officer
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227 WASHINGTON STREET |
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year) 09/30/2019 |
CONSHOHOCKEN, PA 19428 |
4. If Amendment, Date Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Reporting (check applicable line)
_X_ Form Filed by One Reporting Person
___ Form Filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Transaction Date (Month/Day/Year)
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2A. Deemed Execution Date, if any (Month/Day/Year)
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3. Transaction Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Amount
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(A) or (D)
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Price
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Common Stock | 06/02/2015 |
| P4 (1) | 2.5793 | A |
$112.43 | 7,437.3479 | D |
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Common Stock | 09/02/2015 |
| L (2) | 5.8069 | A |
$100.01 | 7,437.3479 | D |
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Common Stock | 12/02/2015 |
| L (3) | 6.8287 | A |
$100 | 7,437.3479 | D |
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Common Stock | 03/08/2016 |
| L (3) | 7.8296 | A |
$87.51 | 7,437.3479 | D |
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Common Stock | 06/07/2016 |
| L (3) | 9.0212 | A |
$76.25 | 7,437.3479 | D |
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Common Stock | 09/07/2016 |
| L (3) | 7.8409 | A |
$88.11 | 7,437.3479 | D |
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Common Stock | 12/06/2016 |
| L (4) | 9.4567 | A |
$78.73 | 7,437.3479 | D |
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Common Stock | 03/07/2017 |
| L (4) | 8.357 | A |
$89.51 | 7,437.3479 | D |
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Common Stock | 06/06/2017 |
| L (4) | 8.1043 | A |
$92.68 | 7,437.3479 | D |
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Common Stock | 09/06/2017 |
| L (4) | 9.4224 | A |
$80.03 | 7,437.3479 | D |
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Common Stock | 12/05/2017 |
| L (5) | 9.2073 | A |
$85.65 | 7,437.3479 | D |
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Common Stock | 03/06/2018 |
| L (5) | 8.3869 | A |
$94.44 | 7,437.3479 | D |
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Common Stock | 06/05/2018 |
| L (5) | 9.4494 | A |
$84.16 | 7,437.3479 | D |
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Common Stock | 09/05/2018 |
| L (5) | 8.9741 | A |
$89.02 | 7,437.3479 | D |
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Common Stock | 12/04/2018 |
| P4 (6) | 9.5492 | A |
$88.44 | 7,437.3479 | D |
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Common Stock | 03/05/2019 |
| P4 (6) | 10.534 | A |
$80.53 | 7,437.3479 | D |
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Common Stock |
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| 6 | I | By Trust (7) |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | 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 control number. | SEC 2270 (9-02) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date (Month/Day/Year)
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3A. Deemed Execution Date, if any (Month/Day/Year)
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4. Transaction Code (Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5)
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6. Date Exercisable and Expiration Date (Month/Day/Year)
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7. Title and Amount of Underlying Securities (Instr. 3 and 4)
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8. Price of Derivative Security (Instr. 5)
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9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Reporting Owners
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Cleary James F 227 WASHINGTON STREET CONSHOHOCKEN, PA 19428 |
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Chief Financial Officer |
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Signatures
John G. Chou for James Cleary | | 11/12/2019 |
**Signature of Reporting Person | Date |
Explanation of Responses:
* | If the form is filed by more than one reporting person, see Instruction 4(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) | This purchase consisted of automatic broker-administered dividend reinvestment activity and should have been reported with the Form 4 filed on August 11, 2015. |
(2) | This purchase consisted of automatic broker-administered dividend reinvestment activity and should have been reported on a Form 5 for the fiscal year ended September 30, 2015. |
(3) | These purchases consisted of automatic broker-administered dividend reinvestment activity and should have been reported on a Form 5 for the fiscal year ended September 30, 2016. |
(4) | These purchases consisted of automatic broker-administered dividend reinvestment activity and should have been reported on a Form 5 for the fiscal year ended September 30, 2017. |
(5) | These purchases consisted of automatic broker-administered dividend reinvestment activity and should have been reported on a Form 5 for the fiscal year ended September 30, 2018. |
(6) | These purchases consisted of automatic broker-administered dividend reinvestment activity and should have been reported with the Form 4 filed on March 6, 2019. |
(7) | The Form 4 filed on March 28, 2019 listed 6 shares of common stock as having been purchased directly by Mr. Cleary but were actually purchased by a family trust and thus are indirectly owned by Mr. Cleary. |
Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
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