0001493152-22-019586.txt : 20220718 0001493152-22-019586.hdr.sgml : 20220718 20220718161524 ACCESSION NUMBER: 0001493152-22-019586 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220714 FILED AS OF DATE: 20220718 DATE AS OF CHANGE: 20220718 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Appajosyula Sireesh CENTRAL INDEX KEY: 0001901565 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41210 FILM NUMBER: 221089327 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 4 1 ownership.xml X0306 4 2022-07-14 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 2022-07-14 4 G 0 75757 0 D 0 I See footnote Common Stock 2022-07-14 4 G 0 7576 0 A 7576 I See footnote The shares of common stock were owned by Mercer Lake Group LLC. Sireesh Appajosyula is the Managing Member of Mercer Lake Group LLC and in such capacity had the right to vote and dispose of the securities held by such entity. The shares of common stock are owned by Channel BioConsulting, LLC. Sireesh Appajosyula is the Managing Member of Channel BioConsulting, LLC and in such capacity has the right to vote and dispose of the securities held by such entity. /s/ Randy Milby as Attorney-In-Fact for Sireesh Appajosyula 2022-07-18