0001683168-21-000740.txt : 20210301
0001683168-21-000740.hdr.sgml : 20210301
20210301153459
ACCESSION NUMBER: 0001683168-21-000740
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210225
FILED AS OF DATE: 20210301
DATE AS OF CHANGE: 20210301
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: 21697375
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
2021-02-25
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
Common Stock
2021-02-25
4
M
0
86250
2.46
A
927350
D
Common Stock
125000
I
See Footnote
Employee Stock option(Right to Buy)
2.46
2021-02-25
4
M
0
86250
0
D
2012-06-14
2021-08-02
Common Stock
86250
0
D
The reported securities are held by the Iwaki Family Limited Partnership. The reporting person is the general partner of the partnership that owns the reported securities. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
/s/ Yuichi Iwaki
2021-03-01