0001493152-19-018862.txt : 20191206 0001493152-19-018862.hdr.sgml : 20191206 20191206172658 ACCESSION NUMBER: 0001493152-19-018862 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191203 FILED AS OF DATE: 20191206 DATE AS OF CHANGE: 20191206 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DIGIANDOMENICO ANTHONY CENTRAL INDEX KEY: 0001083544 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38552 FILM NUMBER: 191273890 MAIL ADDRESS: STREET 1: 3600 GREEN COURT, SUITE 350 CITY: ANN ARBOR STATE: MI ZIP: 48105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Provention Bio, Inc. CENTRAL INDEX KEY: 0001695357 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: P.O. BOX 666 CITY: OLDWICK STATE: NJ ZIP: 08858 BUSINESS PHONE: 908-428-9136 MAIL ADDRESS: STREET 1: P.O. BOX 666 CITY: OLDWICK STATE: NJ ZIP: 08858 FORMER COMPANY: FORMER CONFORMED NAME: Provention Inc. DATE OF NAME CHANGE: 20170120 4 1 ownership.xml X0306 4 2019-12-03 0 0001695357 Provention Bio, Inc. PRVB 0001083544 DIGIANDOMENICO ANTHONY C/O PROVENTION BIO, INC. P.O. BOX 666 OLDWICK NJ 08858 1 0 0 0 Common Stock 2019-12-03 4 J 0 342000 0 A 520712 D Pro rata distribution from MDB Capital Group LLC, of which the reporting person is a minority owner. /s/ Andrew Drechsler, as attorney-in-fact 2019-12-06