0001209191-22-010809.txt : 20220217
0001209191-22-010809.hdr.sgml : 20220217
20220217164605
ACCESSION NUMBER: 0001209191-22-010809
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20220215
FILED AS OF DATE: 20220217
DATE AS OF CHANGE: 20220217
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bharucha David
CENTRAL INDEX KEY: 0001910985
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38899
FILM NUMBER: 22648844
MAIL ADDRESS:
STREET 1: C/O MILESTONE PHARMACEUTICALS INC.
STREET 2: 1111 DR. FREDERIK-PHILIPS BLVD., STE 420
CITY: MONTREAL
STATE: A8
ZIP: H4M 2X6
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Milestone Pharmaceuticals Inc.
CENTRAL INDEX KEY: 0001408443
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: A8
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1111 BOUL. DR.-FREDERIK-PHILIPS, STE 420
CITY: MONTREAL
STATE: A8
ZIP: H4M 2X6
BUSINESS PHONE: (514) 336-0444
MAIL ADDRESS:
STREET 1: 1111 BOUL. DR.-FREDERIK-PHILIPS, STE 420
CITY: MONTREAL
STATE: A8
ZIP: H4M 2X6
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2022-02-15
1
0001408443
Milestone Pharmaceuticals Inc.
MIST
0001910985
Bharucha David
C/O MILESTONE PHARMACEUTICALS INC.
1111 DR. FREDERIK-PHILIPS BLVD, STE 420
MONTREAL
A8
H4M 2X6
QUEBEC, CANADA
0
1
0
0
Chief Medical Officer
No securities beneficially owned.
Exhibit List - Exhibit 24 - Power of Attorney
/s/ Jason Minio, Attorney-in-Fact
2022-02-17
EX-24
2
poa.txt
POA DOCUMENT
Exhibit 24
POWER OF ATTORNEY
(For Executing Form ID and Forms 3, 4 and 5)
Know all by these presents, that the undersigned hereby constitutes and
appoints each of Joseph Oliveto and Amit Hasija of Milestone Pharmaceuticals
Inc. (the "Company"), and Jason Minio, Ryan Sonberg and Eric Popp of Cooley LLP,
signing individually, the undersigned's true and lawful attorneys-in fact and
agents to:
(1) Prepare, execute in the undersigned's name and on the undersigned's behalf,
and submit to the Securities and Exchange Commission (the "SEC"), a Form ID and
Forms 3, 4 and 5 (including amendments thereto and joint filing agreements in
connection therewith) in accordance with Section 16 of the Securities Exchange
Act of 1934, as amended (the "Exchange Act"), and the rules thereunder, in the
undersigned's capacity as an officer, director or beneficial owner of more than
10% of a registered class of securities of the Company;
(2) Do and perform any and all acts for and on behalf of the undersigned that
may be necessary or desirable to prepare and execute any such Form ID and Forms
3, 4 or 5 (including amendments thereto and joint filing agreements in
connection therewith) and file such forms with the SEC and any stock exchange,
self-regulatory association or any similar authority; and
(3) Take any other action of any type whatsoever in connection with the
foregoing that, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required of the undersigned, it being
understood that the documents executed by the attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as the attorney-in-fact may approve in the
attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney in fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney in fact, or such attorney
in fact's substitute or substitutes, shall lawfully do or cause to be done by
virtue of this power of attorney and the rights and powers herein granted. The
undersigned acknowledges that the foregoing attorneys-in-fact, and their
substitutes, in serving in such capacity at the request of the undersigned, are
not assuming (nor is the Company assuming) any of the undersigned's
responsibilities to comply with Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until the earliest
to occur of (a) the undersigned is no longer required to file Forms 3, 4 and 5
with respect to the undersigned's holdings of and transactions in securities
issued by the Company, (b) revocation by the undersigned in a signed writing
delivered to the Company and the foregoing attorneys-in fact or (c) as to any
attorney-in-fact individually, until such attorney-in-fact is no longer employed
by the Company or employed by or a partner at Cooley LLP or another law firm
representing the Company, as applicable.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of the date written below.
Date: February 6, 2022
/s/ David Bharucha
David Bharucha