0001104659-22-000550.txt : 20220103
0001104659-22-000550.hdr.sgml : 20220103
20220103190233
ACCESSION NUMBER: 0001104659-22-000550
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211229
FILED AS OF DATE: 20220103
DATE AS OF CHANGE: 20220103
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Fodor William
CENTRAL INDEX KEY: 0001735547
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35853
FILM NUMBER: 22503480
MAIL ADDRESS:
STREET 1: C/O BIOSTAGE, INC., 84 OCTOBER HILL ROAD
CITY: HOLLISTON
STATE: MA
ZIP: 01746
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Biostage, Inc.
CENTRAL INDEX KEY: 0001563665
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 455210462
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 84 OCTOBER HILL ROAD
STREET 2: SUITE 11
CITY: HOLLISTON
STATE: MA
ZIP: 01746
BUSINESS PHONE: (774) 233-7300
MAIL ADDRESS:
STREET 1: 84 OCTOBER HILL ROAD
STREET 2: SUITE 11
CITY: HOLLISTON
STATE: MA
ZIP: 01746
FORMER COMPANY:
FORMER CONFORMED NAME: Harvard Apparatus Regenerative Technology, Inc.
DATE OF NAME CHANGE: 20121204
4
1
tm221395-2_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-12-29
0
0001563665
Biostage, Inc.
BSTG
0001735547
Fodor William
C/O BIOSTAGE, INC.
84 OCTOBER HILL ROAD, SUITE 11
HOLLISTON
MA
01746
0
1
0
0
Chief Scientific Officer
Stock Option (right to buy)
2.30
2021-12-29
4
A
0
196103
0
A
2031-12-29
Common Stock, par value $0.01 per share
196103
196103
D
Subject to continued employment or service through the applicable vesting dates, these shares vest in four equal amounts on each of the grant date and each anniversary of the grant date.
This form has been signed under power of attorney.
/s/ Chad Porter, by power of attorney
2022-01-03