0001144204-17-053029.txt : 20171018
0001144204-17-053029.hdr.sgml : 20171018
20171018161654
ACCESSION NUMBER: 0001144204-17-053029
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171017
FILED AS OF DATE: 20171018
DATE AS OF CHANGE: 20171018
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Duncan Barbara Gayle
CENTRAL INDEX KEY: 0001353128
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35112
FILM NUMBER: 171142778
MAIL ADDRESS:
STREET 1: C/O INTERCEPT PHARMACEUTICALS, INC.
STREET 2: 18 DESBROSSES STREET
CITY: NEW YORK
STATE: NY
ZIP: 10013
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Aevi Genomic Medicine, Inc.
CENTRAL INDEX KEY: 0001138776
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 980217544
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 435 DEVON PARK DRIVE,
STREET 2: SUITE 715
CITY: WAYNE
STATE: PA
ZIP: 19087
BUSINESS PHONE: 610-254-4201
MAIL ADDRESS:
STREET 1: 435 DEVON PARK DRIVE,
STREET 2: SUITE 715
CITY: WAYNE
STATE: PA
ZIP: 19087
FORMER COMPANY:
FORMER CONFORMED NAME: MEDGENICS, INC.
DATE OF NAME CHANGE: 20090623
FORMER COMPANY:
FORMER CONFORMED NAME: MEDGENICS INC
DATE OF NAME CHANGE: 20010419
4
1
tv477168_4.xml
OWNERSHIP DOCUMENT
X0306
4
2017-10-17
0
0001138776
Aevi Genomic Medicine, Inc.
GNMX
0001353128
Duncan Barbara Gayle
C/O AEVI GENOMIC MEDICINE, INC.
435 DEVON PARK DRIVE, SUITE 715
WAYNE
PA
19087
1
0
0
0
Common Stock
2017-10-17
4
P
0
59524
1.26
A
59524
D
Warrant (right to buy)
2.84
2017-10-17
4
P
0
10591
0
A
2017-10-17
2022-10-17
Common Stock
10591
10591
D
/s/ Brian Piper as Attorney-In-Fact For Barbara Gayle Duncan
2017-10-18