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