0001144204-16-128963.txt : 20161021 0001144204-16-128963.hdr.sgml : 20161021 20161021160542 ACCESSION NUMBER: 0001144204-16-128963 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161020 FILED AS OF DATE: 20161021 DATE AS OF CHANGE: 20161021 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INTERLEUKIN GENETICS INC CENTRAL INDEX KEY: 0001037649 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 943123681 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 135 BEAVER ST CITY: WATHAM STATE: MA ZIP: 02452 BUSINESS PHONE: 1-781-398-0700 MAIL ADDRESS: STREET 1: 135 BEAVER ST CITY: WATHAM STATE: MA ZIP: 02452 FORMER COMPANY: FORMER CONFORMED NAME: MEDICAL SCIENCE SYSTEMS INC DATE OF NAME CHANGE: 19971003 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Carbeau Mark B CENTRAL INDEX KEY: 0001339155 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32715 FILM NUMBER: 161946350 MAIL ADDRESS: STREET 1: C/O KINETIC CONCEPTS, INC STREET 2: 8023 VANTAGE DRIVE CITY: SAN ANTONIO STATE: TX ZIP: 78230 4 1 v450890_4.xml OWNERSHIP DOCUMENT X0306 4 2016-10-20 0 0001037649 INTERLEUKIN GENETICS INC ILIU 0001339155 Carbeau Mark B C/O INTERLEUKIN GENETICS, INC. 135 BEAVER STREET WALTHAM MA 02452 1 1 0 0 CEO Stock Option (Right to Buy) 0.1754 2016-10-20 4 A 0 5000000 0 A 2026-10-20 Common Stock 5000000 5000000 D The exercise price of the option is the closing price of the Issuer's common stock on the OTCQB on October 20, 2016, which was the grant date of the option. The option was granted pursuant to the terms of Mr. Carbeau's employment agreement, dated April 6, 2015, which provided that he would be entitled to such a grant following a Qualified Financing (as defined in the agreement) for Interleukin Genetics, Inc. The option vests as to 25% of the shares on October 20, 2017, and 1/36th of the shares on the first day of each month beginning on November 1, 2017. /s/ Brian P. Keane, Attorney-in-Fact 2016-10-21