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