0001683168-21-001543.txt : 20210426 0001683168-21-001543.hdr.sgml : 20210426 20210426202516 ACCESSION NUMBER: 0001683168-21-001543 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210422 FILED AS OF DATE: 20210426 DATE AS OF CHANGE: 20210426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gaeta Federico C.A. CENTRAL INDEX KEY: 0001859057 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33185 FILM NUMBER: 21855547 MAIL ADDRESS: STREET 1: 4275 EXECUTIVE SQUARE, SUITE 300 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 2021-04-22 0 0001226616 MEDICINOVA INC MNOV 0001859057 Gaeta Federico C.A. C/O MEDICINOVA, INC. 4275 EXECUTIVE SQUARE, SUITE 300 LA JOLLA CA 92037 0 1 0 0 Chief Scientific Officer Employee Stock Option (Right to Buy) 4.56 2021-04-22 4 A 0 24000 0 A 2031-04-22 Common Stock 24000 24000 D The option vests in equal monthly installments over a period of three (3) years commencing April 22, 2021, subject to continued service with the Company. /s/ Federico C.A. Gaeta 2021-04-26