0001683168-20-003513.txt : 20201022 0001683168-20-003513.hdr.sgml : 20201022 20201022163001 ACCESSION NUMBER: 0001683168-20-003513 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201020 FILED AS OF DATE: 20201022 DATE AS OF CHANGE: 20201022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BEAVER CAROLYN CENTRAL INDEX KEY: 0001335581 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33185 FILM NUMBER: 201255179 MAIL ADDRESS: STREET 1: 3595 JOHN HOPKINS COURT CITY: SAN DIEGO STATE: CA ZIP: 92121 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 300 CITY: LA JOLLA STATE: CA ZIP: 92037 BUSINESS PHONE: 858-373-1500 MAIL ADDRESS: STREET 1: 4275 EXECUTIVE SQUARE STREET 2: SUITE 300 CITY: LA JOLLA STATE: CA ZIP: 92037 4 1 ownership.xml X0306 4 2020-10-20 0 0001226616 MEDICINOVA INC MNOV 0001335581 BEAVER CAROLYN C/O MEDICINOVA, INC. 4275 EXECUTIVE SQUARE, SUITE 300 LA JOLLA CA 92037 1 0 0 0 Stock Option (Right to Buy) 5.40 2020-10-20 4 A 0 15000 0 A 2030-10-19 Common Stock 15000 15000 D The option vests in three equal installments on December 31, 2020, March 31, 2021 and June 30, 2021, subject to continued service with the Company. /s/ Carolyn D. Beaver 2020-10-22