Filing Details

*

The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

1.

Names of Reporting Persons

Travis C. Mickle

2.

Check the Appropriate Box if a Member of a Group (see instructions)

(a) ☐ (b) ☐

3.

SEC USE ONLY

4.

Citizenship or Place of Organization

United States

Number of

Shares

Beneficially

Owned by

Each

Reporting

Person

With:

5.

Sole Voting Power

2,833,246 shares (1)

6.

Shared Voting Power

419,034 shares (2)

7.

Sole Dispositive Power

2,833,246 shares (1)

8.

Shared Dispositive Power

419,034 shares (2)

9.

Aggregate Amount Beneficially Owned by Each Reporting Person

3,252,280 shares (1)(2)

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (see instructions) ☐

11.

Percent of Class Represented by Amount in Row 9

8.9% (3)

12.

Type of Reporting Person (see instructions)

IN

1.

Consists of 1,753,117 shares of common stock held directly by Travis C. Mickle (“Dr. Mickle”), 243,880 shares of common stock held by the Christal M.M. Mickle 2015 Gift Trust u/d/p July 21, 2015, for which Dr. Mickle serves as trustee, and 836,249 shares of common stock which Dr. Mickle has the right to acquire within sixty days of December 31, 2019 upon exercise of outstanding stock options.

2.

Consists of 100,604 shares of common stock held jointly with Christal M.M. Mickle (“Ms. Mickle”), 157,197 shares of common stock held by the Travis C. Mickle 2015 Dynasty Trust u/d/p July 21, 2015, for which Ms. Mickle serves as trustee, 123,217 shares of common stock held by the Mickle Family Trust u/d/p April 30, 2009, for which Dr. Mickle and Ms. Mickle serve as co-trustees, 21,466 shares of common stock held by the TCM Family Trust u/d/p April 30, 2009, for which Dr. Mickle and Ms. Mickle serve as co-trustees, and 16,550 shares of common stock held by Mickle Investments LLC, for which Dr. Mickle and Ms. Mickle serve as managing members. 

3.

This percentage is calculated based upon 36,350,785 shares of the Issuer’s common stock outstanding as of December 31, 2019 as provided by KemPharm, Inc.

Item 1(a)

Name of Issuer

Item 1(b)

Address of Issuer’s Principal Executive Offices

Item 2(a)

Name of Person Filing

Item 2(b)

Address of Principal Business Office or, if none, Residence

Item 2(c)

Citizenship

Item 2(d)

Title of Class of Securities

Item 2(e)

CUSIP Number

Item 3

Item 4

Ownership

Holder (1)

Shares Held
Directly

Sole Voting
Power

Shared
Voting
Power

Sole
Dispositive
Power

Shared
Dispositive
Power

Beneficial
Ownership

Percentage of
Class (1)

Travis C. Mickle

2,833,246

(2)

2,833,246

(2)

419,034

(3)

2,833,246

(2)

419,034

(3)

3,252,280

(2)(3)

8.9%

(1)

This percentage is calculated based upon 36,350,785 shares of the Issuer’s common stock outstanding as of December 31, 2019 as disclosed by KemPharm, Inc.

(2)

Consists of 1,753,117 shares of common stock held directly by Travis C. Mickle (“Dr. Mickle”), 243,880 shares of common stock held by the Christal M.M. Mickle 2015 Gift Trust u/d/p July 21, 2015, for which Dr. Mickle serves as trustee, and 836,249 shares of common stock which Dr. Mickle has the right to acquire within sixty days of December 31, 2019 upon exercise of outstanding stock options.

(3)

Consists of 100,604 shares of common stock held jointly by Dr. Mickle and Christal M.M. Mickle (“Ms. Mickle”), 157,197 shares of common stock stock held by the Travis C. Mickle 2015 Dynasty Trust u/d/p July 21, 2015, for which Ms. Mickle serves as trustee, 123,217 shares of common stock held by the Mickle Family Trust u/d/p April 30, 2009, for which Dr. Mickle and Ms. Mickle serve as co-trustees, 21,466 shares of common stock held by the TCM Family Trust u/d/p April 30, 2009, for which Dr. Mickle and Ms. Mickle serve as co-trustees, and 16,550 shares of common stock held by Mickle Investments LLC, for which Dr. Mickle and Ms. Mickle serve as managing members.

Item 5

Ownership of Five Percent or Less of a Class

Item 6

Ownership of More than Five Percent of Another Person

Item 7

Identification and Classification of the Subsidiary which Acquired the Security Being Reported on by the Parent Holding Company

Item 8

Identification and Classification of Members of the Group

Item 9

Notice of Dissolution of Group

Item 10

Certification

/s/ Travis C. Mickle

Travis C. Mickle, Ph.D.