0001683168-24-004154.txt : 20240612 0001683168-24-004154.hdr.sgml : 20240612 20240612194009 ACCESSION NUMBER: 0001683168-24-004154 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240611 FILED AS OF DATE: 20240612 DATE AS OF CHANGE: 20240612 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BEAVER CAROLYN CENTRAL INDEX KEY: 0001335581 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33185 FILM NUMBER: 241039718 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] ORGANIZATION NAME: 03 Life Sciences 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 X0508 4 2024-06-11 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 0 Stock Option (Right to Buy) 1.34 2024-06-11 4 A 0 20000 0 A 2034-06-10 Common Stock 20000 20000 D The option vests in four equal installments on September 30, 2024, December 31, 2024, March 31, 2025 and June 30, 2025, subject to continued service with the Company. /s/ Yuichi Iwaki, attorney-in-fact 2024-06-12