0001628280-16-021749.txt : 20161201 0001628280-16-021749.hdr.sgml : 20161201 20161201105757 ACCESSION NUMBER: 0001628280-16-021749 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161129 FILED AS OF DATE: 20161201 DATE AS OF CHANGE: 20161201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Bellerophon Therapeutics, Inc. CENTRAL INDEX KEY: 0001600132 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 473116175 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 184 LIBERTY CORNER ROAD, SUITE 302 CITY: WARREN STATE: NJ ZIP: 07059 BUSINESS PHONE: 908-574-4770 MAIL ADDRESS: STREET 1: 184 LIBERTY CORNER ROAD, SUITE 302 CITY: WARREN STATE: NJ ZIP: 07059 FORMER COMPANY: FORMER CONFORMED NAME: Bellerophon Therapeutics LLC DATE OF NAME CHANGE: 20140213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Amin Naseem CENTRAL INDEX KEY: 0001646754 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36845 FILM NUMBER: 162027318 MAIL ADDRESS: STREET 1: 53 FRONTAGE ROAD, SUITE 301 CITY: HAMPTON STATE: NJ ZIP: 08827 4 1 wf-form4_148060786428555.xml FORM 4 X0306 4 2016-11-29 0 0001600132 Bellerophon Therapeutics, Inc. BLPH 0001646754 Amin Naseem C/O BELLEROPHON THERAPEUTICS, INC. 184 LIBERTY CORNER ROAD, SUITE 302 WARREN NJ 07059 1 0 0 0 Common Stock 2016-11-29 4 P 0 714285 A 737650 D Common Stock Warrants (right to buy) 0.8 2016-11-29 4 P 0 714285 A 2016-11-29 2021-11-29 Common Stock 714285.0 714285 D The reported securities are included within 714,285 Class A Units purchased by the reporting person for $0.70 per Class A Unit. Each Class A Unit consists of one share of common stock and one warrant to purchase one share of common stock /s/ Naseem Amin 2016-12-01