0001493152-22-001680.txt : 20220120
0001493152-22-001680.hdr.sgml : 20220120
20220120092650
ACCESSION NUMBER: 0001493152-22-001680
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: 22540881
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
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2022-01-14
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A
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3.20
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3.20
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Common Stock
2022-01-14
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0
11545
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Common Stock
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Common Stock
2022-01-14
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Common Stock
2022-01-14
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C
0
19296
3.20
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2528614
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Common Stock
2022-01-14
4
C
0
9639
3.20
A
2538253
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Common Stock
2022-01-14
4
C
0
22420
3.20
A
2560673
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Common Stock
2022-01-14
4
C
0
35175
3.20
A
2595848
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Common Stock
2022-01-14
4
C
0
26325
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2622173
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C
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9572
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Common Stock
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0
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2022-01-14
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C
0
25000
0
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Common stock
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Convertible Note
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2022-01-14
4
C
0
35000
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Common stock
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Convertible Note
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2022-01-14
4
C
0
10000
0
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Common stock
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Convertible Note
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2022-01-14
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C
0
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Convertible Note
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2022-01-14
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0
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Common stock
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2022-01-14
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C
0
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Common stock
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2022-01-14
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C
0
59990
0
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Common stock
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Convertible Note
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2022-01-14
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C
0
30000
0
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Common stock
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Convertible Note
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2022-01-14
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C
0
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0
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Common stock
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0
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Options (right to purchase)
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0
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2032-01-14
Common stock
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On April 19, 2021, the Registrant issued the Reporting Person a $25,000 note which matures on the earlier of (i) April 19, 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 April 30, 2021, the Registrant issued the Reporting Person a $35,000 note which matures on the earlier of (i) April 30, 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 May 10, 2021, the Registrant issued the Reporting Person a $10,000 note which matures on the earlier of (i) May 10, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall 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 May 15, 2021, the Registrant issued the Reporting Person a $35,750 note which matures on the earlier of (i) May 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 May 25, 2021, the Registrant issued the Reporting Person a $90,000 note which matures on the earlier of (i) May 25, 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 May 29, 2021, the Registrant issued the Reporting Person an $88,000 note which matures on the earlier of (i) May 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.
On June 14, 2021, the Registrant issued the Reporting Person a $59,990 note which matures on the earlier of (i) June 14, 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 June 22, 2021, the Registrant issued the Reporting Person a $30,000 note which matures on the earlier of (i) June 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 July 16, 2021, the Registrant issued the Reporting Person a $70,000 note which matures on the earlier of (i) July 17, 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 July 28, 2021, the Registrant issued the Reporting Person a $110,000 note which matures on the earlier of (i) July 28, 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 August 13, 2021, the Registrant issued the Reporting Person an $82,500 note which matures on the earlier of (i) August 13, 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 October 14, 2021, the Registrant issued the Reporting Person a $30,250 note which matures on the earlier of (i) October 14, 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 November 12, 2021, the Registrant issued the Reporting Person a $99,000 note which matures on the earlier of (i) November 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 December 15, 2021, the Registrant issued the Reporting Person a $99,000 note which matures on the earlier of (i) December 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.
The Registrant issued the Reporting Person options on January 14, 2022. The options vest over a 48 month period commencing 12 months after the date of grant.
This is the third of the Form 4s.
/s/ Randy Milby
2022-01-20