0001493152-22-033638.txt : 20221123
0001493152-22-033638.hdr.sgml : 20221123
20221123212521
ACCESSION NUMBER: 0001493152-22-033638
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221122
FILED AS OF DATE: 20221123
DATE AS OF CHANGE: 20221123
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ramos Eleanor
CENTRAL INDEX KEY: 0001464907
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38552
FILM NUMBER: 221417598
MAIL ADDRESS:
STREET 1: ZYMOGENETICS, INC.
STREET 2: 1201 EASTLAKE AVENUE E
CITY: SEATTLE
STATE: WA
ZIP: 98102
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: 55 BROAD STREET, 2ND FLOOR
CITY: RED BANK
STATE: NJ
ZIP: 07701
BUSINESS PHONE: 908-428-9136
MAIL ADDRESS:
STREET 1: 55 BROAD STREET, 2ND FLOOR
CITY: RED BANK
STATE: NJ
ZIP: 07701
FORMER COMPANY:
FORMER CONFORMED NAME: Provention Inc.
DATE OF NAME CHANGE: 20170120
4
1
ownership.xml
X0306
4
2022-11-22
0
0001695357
Provention Bio, Inc.
PRVB
0001464907
Ramos Eleanor
C/O PROVENTION BIO, INC.
55 BROAD STREET, 2ND FLOOR
RED BANK
NJ
07701
0
1
0
0
Chief Medical Officer
Stock Option (right to buy)
12.54
2022-11-22
4
A
0
80000
0
A
2022-11-22
2029-06-24
Common Stock, par value $0.0001
80000
400000
D
As previously reported on a Form 4 filed on June 25, 2019, on June 24, 2019 the Reporting Person was granted a stock option for 400,000 shares of Common Stock, 160,000 of which option shares vest in four equal annual installments commencing on June 24, 2020 and 240,000 of which option shares vest upon completion of certain performance milestones. This amount represents the vesting of 80,000 of the 240,000 performance option shares on November 22, 2022 upon the satisfaction of certain performance milestones. This Form 4 is being filed solely to report the vesting of such previously reported 80,000 option shares.
The stock options were granted pursuant to the Issuer's Amended and Restated 2017 Equity Incentive Plan.
Represents the 160,000 time-based option shares referred to in footnote (1) plus the 80,000 vested performance option shares which vested November 2, 2020 plus 80,000 vested performance option shares which vested November 10, 2020 plus the 80,000 vested performance option shares referred to in footnote (1).
/s/ Thierry Chauche, as attorney-in-fact
2022-11-23