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