0001415889-22-006808.txt : 20220621
0001415889-22-006808.hdr.sgml : 20220621
20220621142146
ACCESSION NUMBER: 0001415889-22-006808
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220616
FILED AS OF DATE: 20220621
DATE AS OF CHANGE: 20220621
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: JACOBSON RACHEL
CENTRAL INDEX KEY: 0001911725
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38365
FILM NUMBER: 221027567
MAIL ADDRESS:
STREET 1: C/O EYENOVIA INC
STREET 2: 295 MADISON AVENUE SUITE 2400
CITY: NEW YORK
STATE: NY
ZIP: 10017
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: EYENOVIA, INC.
CENTRAL INDEX KEY: 0001682639
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 471178401
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 295 MADISON AVENUE,
STREET 2: SUITE 2400
CITY: NEW YORK
STATE: NY
ZIP: 10017
BUSINESS PHONE: 813-766-9539
MAIL ADDRESS:
STREET 1: 295 MADISON AVENUE,
STREET 2: SUITE 2400
CITY: NEW YORK
STATE: NY
ZIP: 10017
4
1
form4-06212022_110637.xml
X0306
4
2022-06-16
0001682639
EYENOVIA, INC.
EYEN
0001911725
JACOBSON RACHEL
C/O EYENOVIA, INC.
295 MADISON AVENUE, SUITE 2400
NEW YORK
NY
10017
true
false
false
false
Common Stock, par value $.0001
2022-06-16
4
A
0
22222
0
A
25511
D
Stock Option (right to buy)
1.80
2022-06-16
4
A
0
30769
0
A
2032-06-16
Common Stock
30769
30769
D
Represents restricted stock units that fully vest on the earlier of June 16, 2023 or the date of the Issuer's 2023 annual meeting of stockholders, subject to the Reporting Person's continued service on the Issuer's Board of Directors and acceleration upon change in control.
The option becomes exercisable on the earlier of June 16, 2023 or the date of the Issuer's 2023 annual meeting of stockholders, subject to the Reporting Person's continued service on the Issuer's Board of Directors and acceleration upon change in control.
/s/ Kaoru C. Suzuki, Attorney-in-Fact
2022-06-21