0001213900-23-000003.txt : 20230103 0001213900-23-000003.hdr.sgml : 20230103 20230103060237 ACCESSION NUMBER: 0001213900-23-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221230 FILED AS OF DATE: 20230103 DATE AS OF CHANGE: 20230103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stilley William B. III CENTRAL INDEX KEY: 0001718069 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38323 FILM NUMBER: 23500040 MAIL ADDRESS: STREET 1: 1180 SEMINOLE TRAIL, SUITE 495 CITY: CHARLOTTESVILLE STATE: VA ZIP: 22901 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ADIAL PHARMACEUTICALS, INC. CENTRAL INDEX KEY: 0001513525 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 800667150 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1180 SEMINOLE TRAIL STREET 2: SUITE 495 CITY: CHARLOTTESVILLE STATE: VA ZIP: 22901 BUSINESS PHONE: 434-422-9800 MAIL ADDRESS: STREET 1: 1180 SEMINOLE TRAIL STREET 2: SUITE 495 CITY: CHARLOTTESVILLE STATE: VA ZIP: 22901 FORMER COMPANY: FORMER CONFORMED NAME: ADial Pharmaceuticals, L.L.C. DATE OF NAME CHANGE: 20170515 FORMER COMPANY: FORMER CONFORMED NAME: Adial Pharmaceuticals, L.L.C. DATE OF NAME CHANGE: 20110218 4 1 ownership.xml X0306 4 2022-12-30 0 0001513525 ADIAL PHARMACEUTICALS, INC. ADIL 0001718069 Stilley William B. III 1180 SEMINOLE TRAIL, SUITE 495 CHARLOTTESVILLE VA 22901 1 0 0 0 Common Stock 2022-12-30 4 D 0 166667 0 D 1020979 D Represents the cancellation of 166,667 previously outstanding shares of restricted common stock of Adial Pharmaceuticals, Inc. originally issued on February 23, 2022. /s/ William B. Stilley, III 2023-01-03