0001493152-22-001677.txt : 20220120
0001493152-22-001677.hdr.sgml : 20220120
20220120092512
ACCESSION NUMBER: 0001493152-22-001677
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220114
FILED AS OF DATE: 20220120
DATE AS OF CHANGE: 20220120
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MILBY RANDY
CENTRAL INDEX KEY: 0001360968
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41210
FILM NUMBER: 22540877
MAIL ADDRESS:
STREET 1: 5 JACK LANE
CITY: NEWARK
STATE: DE
ZIP: 19711
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Hillstream BioPharma Inc.
CENTRAL INDEX KEY: 0001861657
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 842642541
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1200 ROUTE 22 EAST
CITY: BRIDGEWATER
STATE: NJ
ZIP: 08807
BUSINESS PHONE: 302-743-2995
MAIL ADDRESS:
STREET 1: 245 MAIN STREET
STREET 2: SUITE 204
CITY: CHESTER
STATE: NJ
ZIP: 07930
4
1
ownership.xml
X0306
4
2022-01-14
0
0001861657
Hillstream BioPharma Inc.
HILS
0001360968
MILBY RANDY
C/O HILLSTREAM BIOPHARMA, INC.
1200 ROUTE 22 EAST, SUITE 2000
BRIDGEWATER
NJ
08807
1
1
0
0
Chief Executive Officer
Common Stock
2022-01-14
4
C
0
14942
3.20
A
2171992
D
Common Stock
2022-01-14
4
C
0
23205
3.20
A
2195197
D
Common Stock
2022-01-14
4
C
0
406
3.20
A
2195603
D
Common Stock
2022-01-14
4
C
0
23187
3.20
A
2218790
D
Common Stock
2022-01-14
4
C
0
16528
3.20
A
2235318
D
Common Stock
2022-01-14
4
C
0
15824
3.20
A
2251142
D
Common Stock
2022-01-14
4
C
0
6587
3.20
A
2257729
D
Common Stock
2022-01-14
4
C
0
16453
3.20
A
2274182
D
Common Stock
2022-01-14
4
C
0
21653
3.20
A
2295835
D
Common Stock
2022-01-14
4
C
0
13111
3.20
A
2308946
D
Common Stock
2022-01-14
4
C
0
24541
3.20
A
2333487
D
Common Stock
2022-01-14
4
C
0
19613
3.20
A
2353100
D
Common Stock
2022-01-14
4
C
0
22327
3.20
A
2375427
D
Common Stock
2022-01-14
4
C
0
24425
3.20
A
2399852
D
Common Stock
2022-01-14
4
C
0
17872
3.20
A
2417724
D
Convertible Note
3.20
2022-01-14
4
C
0
45000
0
D
Common stock
14942
0
D
Convertible Note
3.20
2022-01-14
4
C
0
70000
0
D
Common stock
23205
0
D
Convertible Note
3.20
2022-01-14
4
C
0
1225.37
0
D
Common stock
406
0
D
Convertible Note
3.20
2022-01-14
4
C
0
70000
0
D
Common stock
23187
0
D
Convertible Note
3.20
2022-01-14
4
C
0
50000
0
D
Common stock
16528
0
D
Convertible Note
3.20
2022-01-14
4
C
0
48000
0
D
Common stock
15824
0
D
Convertible Note
3.20
2022-01-14
4
C
0
20000
0
D
Common stock
6587
0
D
Convertible Note
3.20
2022-01-14
4
C
0
50000
0
D
Common stock
16453
0
D
Convertible Note
3.20
2022-01-14
4
C
0
66000
0
D
Common stock
21653
0
D
Convertible Note
3.20
2022-01-14
4
C
0
40000
0
D
Common stock
13111
0
D
Convertible Note
3.20
2022-01-14
4
C
0
75000
0
D
Common stock
24541
0
D
Convertible Note
3.20
2022-01-14
4
C
0
60000
0
D
Common stock
19613
0
D
Convertible Note
3.20
2022-01-14
4
C
0
68476.50
0
D
Common stock
22327
0
D
Convertible Note
3.20
2022-01-14
4
C
0
75000
0
D
Common stock
24425
0
D
Convertible Note
3.20
2022-01-14
4
C
0
55000
0
D
Common stock
17872
0
D
On October 14, 2020, the Registrant issued the Reporting Person a $45,000 note which matures on the earlier of (i) October 14, 2022 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On October 27, 2020, the Registrant issued the Reporting Person notes in the aggregate principal amount of $70,000. The notes mature on the earlier of (i) October 27, 2022 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the notes together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On November 1, 2020, the Registrant issued the Reporting Person a $1,225.37 note which matures on the earlier of (i) November 1, 2022 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On November 2, 2020, the Registrant issued the Reporting Person a $70,000 note which matures on the earlier of (i) November 2, 2022 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On November 18, 2020, the Registrant issued the Reporting Person a $50,000 note which matures on the earlier of (i) November 18, 2022 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On December 9, 2020, the Registrant issued the Reporting Person a $48,000 note which matures on the earlier of (i) December 9, 2023 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On December 16, 2020, the Registrant issued the Reporting Person a $20,000 note which matures on the earlier of (i) December 16, 2023 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On December 23, 2020, the Registrant issued the Reporting Person a $50,000 note which matures on the earlier of (i) December 23, 2023 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On January 15, 2021, the Registrant issued the Reporting Person a $66,000 note which matures on the earlier of (i) January 15, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On January 22, 2021, the Registrant issued the Reporting Person a $40,000 note which matures on the earlier of (i) January 22, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On February 4, 2021, the Registrant issued the Reporting Person a $75,000 note which matures on the earlier of (i) February 4, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On February 12, 2021, the Registrant issued the Reporting Person a $60,000 note which matures on the earlier of (i) February 12, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On March 3, 2021, the Registrant issued the Reporting Person notes in the aggregate principal amount of $68,476.50. The notes mature on the earlier of (i) March 3, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the notes together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On March 12, 2021, the Registrant issued the Reporting Person a $75,000 note which matures on the earlier of (i) March 12, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
On March 29, 2021, the Registrant issued the Reporting Person a $55,000 note which matures on the earlier of (i) March 29, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon automatically converts into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. Pursuant to the terms of the note, because the Registrant's initial public offering qualified as a Next Equity Financing, the note automatically converted into shares of the Registrant's common stock.
This is the second of the Form 4s.
/s/ Randy Milby
2022-01-20