0001493152-22-000996.txt : 20220111 0001493152-22-000996.hdr.sgml : 20220111 20220111214816 ACCESSION NUMBER: 0001493152-22-000996 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20220111 FILED AS OF DATE: 20220111 DATE AS OF CHANGE: 20220111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Appajosyula Sireesh CENTRAL INDEX KEY: 0001901565 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41210 FILM NUMBER: 22525409 MAIL ADDRESS: STREET 1: 1200 ROUTE 22 EAST STREET 2: SUITE 2000 CITY: BRIDGEWATER STATE: NJ ZIP: 08807 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Hillstream BioPharma Inc. CENTRAL INDEX KEY: 0001861657 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 842642541 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1200 ROUTE 22 EAST CITY: BRIDGEWATER STATE: NJ ZIP: 08807 BUSINESS PHONE: 302-743-2995 MAIL ADDRESS: STREET 1: 245 MAIN STREET STREET 2: SUITE 204 CITY: CHESTER STATE: NJ ZIP: 07930 3 1 ownership.xml X0206 3 2022-01-11 0 0001861657 Hillstream BioPharma Inc. HILS 0001901565 Appajosyula Sireesh C/O HILLSTREAM BIOPHARMA, INC. 1200 ROUTE 22 EAST, SUITE 2000 BRIDGEWATER NJ 08807 1 0 0 0 Common stock 284090 D Common stock 972222 I See footnote Common stock 75757 I See footnote Options (right to purchase) 0.0792 2024-08-30 Common stock 37878 D The shares of common stock are owned by Highpoint Pharmaceuticals LLC. Sireesh Appajosyula is the Managing Member of Highpoint Pharmaceuticals LLC and in such capacity has the right to vote and dispose of the securities held by such entity. The shares of common stock are owned by Mercer Lake Group LLC. Sireesh Appajosyula is the is the Managing Member of Mercer Lake Group LLC and in such capacity has the right to vote and dispose of the securities held by such entity. The Registrant issued the Reporting Person the options on August 30, 2019. The options vested immediately upon grant and become exercisable upon (i) consummation of the Registrant's initial public offering of its securities or (ii) consummation of a reverse merger of the Registrant with and into a public company. Exhibit List: Exhibit 24 - Power of Attorney /s/ Randy Milby as Attorney-In-Fact for Sireesh Appajosyula 2022-01-11 EX-24 2 ex24.htm

 

Exhibit 24

 

POWER OF ATTORNEY

 

KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and appoints Randy Milby with full power to act singly, as the undersigned’s true and lawful attorney-in-fact, with full power of substitution, to:

 

1) execute for and on behalf of the undersigned, in the undersigned’s capacity as an officer and/or director and/or beneficial owner of Hillstream BioPharma, Inc. (the “Company”), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended, and the rules thereunder;
2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the United States Securities and Exchange Commission and any stock exchange or similar authority; and
3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact’s discretion.

 

The undersigned hereby grants to the attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact or such attorney-in-fact’s substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted.

 

This power of attorney shall remain in full force and effect until revoked by the undersigned in a signed writing delivered to the attorney-in-fact.

 

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 5th day of January, 2022.

 

  By: /s/ Sireesh Appajosyula
  Name: Sireesh Appajosyula
  Title: Director