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*
Pavliv Leo

(Last) (First) (Middle)
2525 WEST END AVE.
SUITE 950

(Street)
NASHVILLE TN 37203

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/10/2009
3. Issuer Name and Ticker or Trading Symbol
CUMBERLAND PHARMACEUTICALS INC [ CPIX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Vice President, Operations
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)
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
Options 12/27/1999 12/27/2009 Common Stock 5,000 0.5 D
Options 05/15/2000 05/15/2010 Common Stock 18,000 0.93 D
Options 09/30/2001 09/30/2011 Common Stock 3,000 1.63 D
Options 12/31/2003 04/14/2013 Common Stock 40,000 3.5 D
Options 12/31/2004 04/14/2013 Common Stock 40,000 3.5 D
Options 12/31/2005 04/14/2013 Common Stock 40,000 3.5 D
Options 12/31/2006 04/14/2013 Common Stock 40,000 3.5 D
Options 12/31/2007 02/02/2017 Common Stock 3,000 11 D
Options 12/31/2008 02/02/2017 Common Stock 3,000 11 D
Options 12/31/2008 07/22/2018 Common Stock 2,250 13 D
Options 12/31/2009 01/15/2015 Common Stock 40,000 6 D
Options 12/31/2009 02/02/2017 Common Stock 3,000 11 D
Options 12/31/2009 02/16/2019 Common Stock 2,250 13 D
Options 12/31/2009 07/22/2018 Common Stock 2,250 13 D
Options 12/31/2010 02/02/2017 Common Stock 3,000 11 D
Options 12/31/2010 02/16/2019 Common Stock 2,500 13 D
Options 12/31/2010 07/22/2018 Common Stock 2,250 13 D
Options 12/31/2011 02/16/2019 Common Stock 2,500 13 D
Options 12/31/2011 07/22/2018 Common Stock 2,250 13 D
Options 12/31/2012 02/16/2019 Common Stock 2,500 13 D
Explanation of Responses:
Remarks:
Leo Pavliv by: /s/ Jean W. Marstiller, as Attorney-in-fact 08/10/2009
** 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.