0001493152-20-013475.txt : 20200716 0001493152-20-013475.hdr.sgml : 20200716 20200716180110 ACCESSION NUMBER: 0001493152-20-013475 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200715 FILED AS OF DATE: 20200716 DATE AS OF CHANGE: 20200716 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wysenski Nancy CENTRAL INDEX KEY: 0001294596 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38552 FILM NUMBER: 201032293 MAIL ADDRESS: STREET 1: 2200 SUNBURST STREET CITY: CHATSWORTH STATE: CA ZIP: 90401 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 ownership.xml X0306 4 2020-07-15 0 0001695357 Provention Bio, Inc. PRVB 0001294596 Wysenski Nancy C/O PROVENTION BIO, INC., P.O. BOX 666 OLDWICK, NJ 08858 1 0 0 0 Option (right to buy) 12.62 2020-07-15 4 A 0 22200 0 A 2030-07-15 Common Stock, par value $0.0001 22200 22200 D 22,200 option shares vest on July 15, 2021. The securities were granted pursuant to the Issuer's Amended and Restated 2017 Equity Incentive Plan. /s/ Andrew Drechsler as attorney-in-fact 2020-07-16