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