0001144204-17-051549.txt : 20171005 0001144204-17-051549.hdr.sgml : 20171005 20171005180424 ACCESSION NUMBER: 0001144204-17-051549 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171003 FILED AS OF DATE: 20171005 DATE AS OF CHANGE: 20171005 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PICKER DONALD H CENTRAL INDEX KEY: 0001266800 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37758 FILM NUMBER: 171125430 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Moleculin Biotech, Inc. CENTRAL INDEX KEY: 0001659617 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 474671999 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2575 WEST BELLFORT STREET 2: SUITE 333 CITY: HOUSTON STATE: TX ZIP: 77054 BUSINESS PHONE: 713-300-5160 MAIL ADDRESS: STREET 1: 2575 WEST BELLFORT STREET 2: SUITE 333 CITY: HOUSTON STATE: TX ZIP: 77054 4 1 v476494_4.xml OWNERSHIP DOCUMENT X0306 4 2017-10-03 0 0001659617 Moleculin Biotech, Inc. MBRX 0001266800 PICKER DONALD H C/O MOLECULIN BIOTECH, INC. 2575 WEST BELLFORT, SUITE 333 HOUSTON TX 77054 0 1 0 0 Chief Science Officer Stock option (right to buy) 2.49 2017-10-03 4 A 0 60000 A 2027-10-03 Common stock 60000 60000 D The stock option set forth in this table vests in four equal annual installments beginning on the first anniversary of the Transaction Date, subject to the grantee's continued service to the Company on each vesting date. Issued in connection with the reporting person's employment with the Company. /s/ Donald Picker 2017-10-05