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