0001683168-17-001539.txt : 20170609
0001683168-17-001539.hdr.sgml : 20170609
20170609162137
ACCESSION NUMBER: 0001683168-17-001539
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170608
FILED AS OF DATE: 20170609
DATE AS OF CHANGE: 20170609
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MEDICINOVA INC
CENTRAL INDEX KEY: 0001226616
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 330927979
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4275 EXECUTIVE SQUARE
STREET 2: SUITE 650
CITY: LA JOLLA
STATE: CA
ZIP: 92037
BUSINESS PHONE: 858-373-1500
MAIL ADDRESS:
STREET 1: 4275 EXECUTIVE SQUARE
STREET 2: SUITE 650
CITY: LA JOLLA
STATE: CA
ZIP: 92037
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ishizaka Yoshio
CENTRAL INDEX KEY: 0001603893
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33185
FILM NUMBER: 17903202
MAIL ADDRESS:
STREET 1: 4275 EXECUTIVE SQUARE
STREET 2: SUITE 650
CITY: LA JOLLA
STATE: CA
ZIP: 92037
4
1
ishizaka_f4.xml
FORM 4
X0306
4
2017-06-08
0
0001226616
MEDICINOVA INC
MNOV
0001603893
Ishizaka Yoshio
C/O MEDICINOVA, INC.
4275 EXECUTIVE SQUARE, SUITE 650
LA JOLLA
CA
92037
1
0
0
0
Stock Option (Right to Buy)
5.65
2017-06-08
4
A
0
20000
0
A
2027-06-07
Common Stock
20000
20000
D
The option vests in four equal installments on September 30, 2017, December 31, 2017, March 31, 2018 and June 30, 2018, subject to continued service with the Company.
/s/ Yuichi Iwaki, attorney-in-fact
2017-06-09