0001493152-18-010543.txt : 20180726 0001493152-18-010543.hdr.sgml : 20180726 20180726200017 ACCESSION NUMBER: 0001493152-18-010543 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180719 FILED AS OF DATE: 20180726 DATE AS OF CHANGE: 20180726 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gray Cameron CENTRAL INDEX KEY: 0001590583 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-38552 FILM NUMBER: 18972903 MAIL ADDRESS: STREET 1: 675 W. KENDALL STREET CITY: CAMBRIDGE STATE: MA ZIP: 02142 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: P.O. BOX 666 CITY: OLDWICK STATE: NJ ZIP: 08858 BUSINESS PHONE: 908-428-9136 MAIL ADDRESS: STREET 1: P.O. BOX 666 CITY: OLDWICK STATE: NJ ZIP: 08858 FORMER COMPANY: FORMER CONFORMED NAME: Provention Inc. DATE OF NAME CHANGE: 20170120 4/A 1 ownership.xml X0306 4/A 2018-07-19 2018-07-19 0 0001695357 Provention Bio, Inc. PRVB 0001590583 Gray Cameron C/O PROVENTION BIO, INC. P.O. BOX 666 OLDWICK NJ 08858 1 0 0 0 Warrant (right to buy) 5 2018-07-19 4 J 0 504668 0 A 2019-06-28 2023-07-03 Common Stock, par value $0.0001 504668 504668 D Upon closing of the initial public offering of Provention Bio, Inc., a warrant was issued to MDB Capital Group LLC as partial consideration for services related to the offering. MDB Capital Group assigned a portion of that warrant to reporting person effective July 19, 2018. /s/ Andrew Drechsler, as attorney-in-fact 2018-07-26