0001683168-21-000391.txt : 20210204 0001683168-21-000391.hdr.sgml : 20210204 20210204161625 ACCESSION NUMBER: 0001683168-21-000391 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210202 FILED AS OF DATE: 20210204 DATE AS OF CHANGE: 20210204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: IWAKI YUICHI CENTRAL INDEX KEY: 0001263965 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33185 FILM NUMBER: 21591366 MAIL ADDRESS: STREET 1: C/O MEDICINOVA, INC. STREET 2: 4275 EXECUTIVE SQUARE, SUITE 650 CITY: LA JOLLA STATE: CA ZIP: 92037 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 2021-02-02 0 0001226616 MEDICINOVA INC MNOV 0001263965 IWAKI YUICHI C/O MEDICINOVA, INC. 4275 EXECUTIVE SQUARE, SUITE 300 LA JOLLA CA 92037 1 1 0 0 President and CEO Employee Stock Option (Right to Buy) 6.89 2021-02-02 4 A 0 495000 0 A 2021-02-02 2030-01-08 Common Stock 495000 495000 D On January 09, 2020, the reporting person was granted an option to purchase 550,000 shares of common stock. The option vests based on the satisfaction of certain performance criteria for the fiscal year ended December 31, 2020. Such performance criteria for 2020 were achieved at the 90% attainment level, resulting in vesting of the option as to 495,000 shares. /s/ Yuichi Iwaki 2021-02-04