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