0000899243-16-030259.txt : 20160928 0000899243-16-030259.hdr.sgml : 20160928 20160928182738 ACCESSION NUMBER: 0000899243-16-030259 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160926 FILED AS OF DATE: 20160928 DATE AS OF CHANGE: 20160928 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Novan, Inc. CENTRAL INDEX KEY: 0001467154 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 204427682 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4222 EMPEROR BLVD STREET 2: SUITE 470 CITY: DURHAM STATE: NC ZIP: 27703 BUSINESS PHONE: 919-485-8080 MAIL ADDRESS: STREET 1: 4222 EMPEROR BLVD STREET 2: SUITE 470 CITY: DURHAM STATE: NC ZIP: 27703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Malin Corp plc CENTRAL INDEX KEY: 0001673063 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37880 FILM NUMBER: 161907980 BUSINESS ADDRESS: STREET 1: 2 HARBOUR SQUARE STREET 2: CROFTON ROAD CITY: DUN LAOGHAIRE, CO. DUBLIN STATE: L2 ZIP: ----- BUSINESS PHONE: 353 1 901 5701 MAIL ADDRESS: STREET 1: 2 HARBOUR SQUARE STREET 2: CROFTON ROAD CITY: DUN LAOGHAIRE, CO. DUBLIN STATE: L2 ZIP: ----- REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Malin Life Sciences Holdings Ltd CENTRAL INDEX KEY: 0001685138 STATE OF INCORPORATION: L2 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37880 FILM NUMBER: 161907981 BUSINESS ADDRESS: STREET 1: 2 HARBOUR SQUARE STREET 2: CROFTON ROAD CITY: DUN LAOGHAIRE, CO, DUBLIN STATE: L2 ZIP: ---- BUSINESS PHONE: 353 1 901 5701 MAIL ADDRESS: STREET 1: 2 HARBOUR SQUARE STREET 2: CROFTON ROAD CITY: DUN LAOGHAIRE, CO, DUBLIN STATE: L2 ZIP: ---- 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-09-26 0 0001467154 Novan, Inc. NOVN 0001685138 Malin Life Sciences Holdings Ltd 2 HARBOUR SQUARE, CROFTON ROAD DUN LAOGHAIRE, CO., DUBLIN L2 IRELAND 0 0 1 0 0001673063 Malin Corp plc 2 HARBOUR SQUARE, CROFTON ROAD DUN LAOGHAIRE, CO., DUBLIN L2 IRELAND 0 0 1 0 Common Stock 2016-09-26 4 C 0 1823485 0.00 A 1823485 I See Footnote Common Stock 2016-09-26 4 P 0 800000 11.00 A 2623485 I See Footnote Mezzanine A Stock 2016-09-26 4 C 0 1823485 0.00 D Common Stock 1823485 0 I See Footnote Malin Life Sciences Holdings Limited, the record holder of the shares, is a wholly owned subsidiary of Malin Corporation plc. Malin Corporation plc may be deemed to beneficially own the shares and may be deemed to share voting and dispositive power over these shares. The preferred stock automatically converted into common stock on a 1-to-1 basis upon the closing of the Issuer's initial public offering. Malin Life Sciences Holdings Limited, By: /s/ Richard Peterson, Attorney-in-Fact 2016-09-28 Malin Corporation plc, By: /s/ Richard Peterson, Attorney-in-Fact 2016-09-28