0001104659-21-068838.txt : 20210518
0001104659-21-068838.hdr.sgml : 20210518
20210518160823
ACCESSION NUMBER: 0001104659-21-068838
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210514
FILED AS OF DATE: 20210518
DATE AS OF CHANGE: 20210518
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ammer Richard
CENTRAL INDEX KEY: 0001843671
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40034
FILM NUMBER: 21936031
MAIL ADDRESS:
STREET 1: C/O VALLON PHARMACEUTICALS, INC.
STREET 2: 100 N. 18TH STREET, SUITE 300
CITY: PHILADELPHIA
STATE: PA
ZIP: 19103
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Vallon Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001824293
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 824369909
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: TWO LOGAN SQUARE
STREET 2: 100 N. 18TH STREET, SUITE 300
CITY: PHILADELPHIA
STATE: PA
ZIP: 19103
BUSINESS PHONE: (267) 207-3606
MAIL ADDRESS:
STREET 1: TWO LOGAN SQUARE
STREET 2: 100 N. 18TH STREET, SUITE 300
CITY: PHILADELPHIA
STATE: PA
ZIP: 19103
4
1
tm2116776-6_4.xml
OWNERSHIP DOCUMENT
X0306
4
2021-05-14
0
0001824293
Vallon Pharmaceuticals, Inc.
VLON
0001843671
Ammer Richard
C/O VALLON PHARMACEUTICALS, INC.
100 N. 18TH STREET, SUITE 300
PHILADELPHIA
PA
19103
1
0
0
0
Stock Option (Right to Buy)
3.66
2021-05-14
4
A
0
15000
0.00
A
2031-05-14
Common Stock
15000
15000
D
Stock Option (Right to Buy)
3.66
2021-05-14
4
A
0
10204
0.00
A
2031-05-14
Common Stock
10204
10204
D
The stock option vests in 24 equal monthly installments such that the stock option is fully vested on the second annual anniversary of the date of grant.
The stock option vests as to 50% of the underlying shares of common stock on June 30, 2021, then in two equal installments on September 30, 2021 and December 31, 2021, such that the stock option fully vests on December 31, 2021.
/s/ David Baker, attorney-in-fact
2021-05-18