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