0001140361-18-033671.txt : 20180726
0001140361-18-033671.hdr.sgml : 20180726
20180726165009
ACCESSION NUMBER: 0001140361-18-033671
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180719
FILED AS OF DATE: 20180726
DATE AS OF CHANGE: 20180726
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: APPEL PETER A
CENTRAL INDEX KEY: 0001227104
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38552
FILM NUMBER: 18972268
MAIL ADDRESS:
STREET 1: C/O ARCH CAPITAL HOLDINGS LTD
STREET 2: 20 HORSENECK LANE
CITY: GREENWICH
STATE: CT
ZIP: 06830
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Provention Bio, Inc.
CENTRAL INDEX KEY: 0001695357
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: P.O. BOX 666
CITY: OLDWICK
STATE: NJ
ZIP: 08858
BUSINESS PHONE: 908-428-9136
MAIL ADDRESS:
STREET 1: P.O. BOX 666
CITY: OLDWICK
STATE: NJ
ZIP: 08858
FORMER COMPANY:
FORMER CONFORMED NAME: Provention Inc.
DATE OF NAME CHANGE: 20170120
4
1
doc1.xml
FORM 4
X0306
4
2018-07-19
1
0001695357
Provention Bio, Inc.
PRVB
0001227104
APPEL PETER A
3505 MAIN LODGE DRIVE
COCONUT GROVE
FL
33133
0
0
1
0
Common Stock, par value $0.0001 per share
2018-07-19
4
C
0
1200000
A
1200000
D
Common Stock, par value $0.0001 per share
2018-07-19
4
P
0
750000
4.00
A
1950000
D
The Series A Convertible Preferred Stock converted into Provention Bio, Inc. common stock on a 1-for-1 basis.
The securities were purchased pursuant to an underwritten public offering by the Issuer. The offering closed on July 19, 2018.
/s/ Peter A. Appel
2018-07-26