Amended Statement of Beneficial Ownership
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment
No. 1)*
Cumberland Pharmaceuticals Inc.
Common Stock
(Title of Class of Securities)
December 31,
2010
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
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o
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Rule 13d-1(b)
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o
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Rule 13d-1(c)
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þ
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Rule 13d-1(d)
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*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.
The information required in the remainder of this cover page shall not be deemed to be “filed” for
the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to
the liabilities of that section of the Act but shall be subject to all other provisions of the Act
(however, see the Notes).
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1
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NAMES OF REPORTING PERSONS.
I.R.S. Identification Nos. of above persons (entities only).
A.J. Kazimi
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) Not applicable
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(a)
o
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(b)
o
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3
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SEC USE ONLY
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4
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CITIZENSHIP OR PLACE OF ORGANIZATION
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United States
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5
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SOLE VOTING POWER
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NUMBER OF
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5,517,775
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SHARES
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6
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SHARED VOTING POWER
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BENEFICIALLY
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BY OWNED BY
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None
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EACH
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7
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SOLE DISPOSITIVE POWER
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REPORTING
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PERSON
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5,517,775
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WITH:
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8
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SHARED DISPOSITIVE POWER
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None
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9
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
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5,517,775
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10
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CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
Not applicable
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o
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11
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
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27.1%
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12
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TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
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IN
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Page 2 of 5 pages
Item 1.
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(a)
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Name of Issuer
Cumberland Pharmaceuticals Inc.
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(b)
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Address of Issuer’s Principal Executive Offices
2525 West End Avenue, Suite 950,
Nashville, TN 37203
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Item 2.
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(a)
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Name of Person Filing
A.J. Kazimi
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(b)
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Address of Principal Business Office or, if none, Residence
2525 West End Avenue, Suite
950, Nashville, TN 37203
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(c)
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Citizenship
United States
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(d)
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Title of Class of Securities
Common Stock
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(e)
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CUSIP Number
230770109
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Item 3.
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If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether
the person filing is a:
Not applicable
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Page 3 of 5 pages
Item 4. Ownership.
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(a)
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Amount beneficially owned:
5,517,775.
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(b)
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Percent of class:
27.1%.
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(c)
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Number of shares as to which the person has:
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(i)
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Sole power to vote or to direct the vote
5,517,775.
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(ii)
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Shared power to vote or to direct the vote
None.
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(iii)
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Sole power to dispose or to direct the disposition of
5,517,775.
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(iv)
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Shared power to dispose or to direct the disposition of
None.
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Item 5. Ownership of Five Percent or Less of a Class
Not applicable
Item 6. Ownership of More than Five Percent on Behalf of Another Person.
Not applicable
Item 7.
Identification and Classification of the Subsidiary Which Acquired the Security Being
Reported on By the Parent Holding
Company
Not applicable
Item 8. Identification and Classification of Members of the Group
Not applicable
Item 9. Notice of Dissolution of Group
Not applicable
Item 10. Certification
Not applicable
Page 4 of 5 pages
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I certify that the
information set forth in this statement is true, complete and correct.
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February 14, 2011
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Date
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/s/ A.J. Kazimi
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Signature
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A.J. Kazimi
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Name/Title
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Page 5 of 5 pages