0001493152-22-010294.txt : 20220419 0001493152-22-010294.hdr.sgml : 20220419 20220419080522 ACCESSION NUMBER: 0001493152-22-010294 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220418 FILED AS OF DATE: 20220419 DATE AS OF CHANGE: 20220419 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: 22833504 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 2022-04-18 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 2022-04-18 4 X 0 7575 0.314 A 2701588 D Common Stock 2022-04-18 4 X 0 7575 0.314 A 2709163 D Common Stock 2022-04-18 4 X 0 189393 0.079 A 2898556 D Common Stock 2022-04-18 4 X 0 28408 0.079 A 2926964 D Common Stock 2022-04-18 4 X 0 7575 0.314 A 2934539 D Options (right to purchase) 0.314 2022-04-18 4 X 0 7575 0 D 2020-02-29 2030-02-28 Common stock 7575 0 D Options (right to purchase) 0.314 2022-04-18 4 X 0 7575 0 D 2020-01-31 2030-01-31 Common stock 7575 0 D Options (right to purchase) 0.079 2022-04-18 4 X 0 189393 0 D 2024-08-30 Common stock 189393 0 D Options (right to purchase) 0.079 2022-04-18 4 X 0 28408 0 D 2024-07-31 Common stock 28408 9470 D Options (right to purchase) 0.314 2022-04-18 4 X 0 7575 0 D 2020-03-31 2030-03-31 Common stock 7575 0 D The Registrant issued the Reporting Person the options on August 30, 2019. The options vested on the date of grant and became exercisable upon completion of the Registrant's initial public offering. The Registrant issued the Reporting Person the options on July 31, 2019. The options vest as follows: (i) 9,469 options vested and became exercisable on July 31, 2020 and (ii) the balance of the options shall vest and become exercisable in 48 equal monthly installments such that the options shall vest in full by the 4th anniversary of the initial issuance date. /s/ Randy Milby 2022-04-19