0001493152-22-001751.txt : 20220120
0001493152-22-001751.hdr.sgml : 20220120
20220120171948
ACCESSION NUMBER: 0001493152-22-001751
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220119
FILED AS OF DATE: 20220120
DATE AS OF CHANGE: 20220120
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Palmer Ashleigh
CENTRAL INDEX KEY: 0001493714
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38552
FILM NUMBER: 22543199
MAIL ADDRESS:
STREET 1: PROVENTION BIO, INC.
STREET 2: 110 OLD DRIFTWAY LANE
CITY: LEBANON
STATE: NJ
ZIP: 08833
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
2022-01-19
0
0001695357
Provention Bio, Inc.
PRVB
0001493714
Palmer Ashleigh
C/O PROVENTION BIO, INC.
55 BROAD STREET, 2ND FLOOR
RED BANK
NJ
07701
1
1
0
0
Director and CEO
Stock Option (right to buy)
4.37
2022-01-19
4
A
0
360000
0
A
2032-01-19
Common Stock, par value $0.0001
360000
360000
D
The options will vest and become exercisable as to 25% on the one-year anniversary of the grant date (January 19, 2023) and the remaining 75% will vest and become exercisable monthly over 36 months such that the options are fully vested and exercisable on the four-year anniversary of the grant date (January 19, 2026).
The securities were granted pursuant to the Issuer's Amended and Restated 2017 Equity Incentive Plan.
/s/ Thierry Chauche, as attorney-in-fact
2022-01-20