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