0001213900-23-097818.txt : 20231221 0001213900-23-097818.hdr.sgml : 20231221 20231221205318 ACCESSION NUMBER: 0001213900-23-097818 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231221 FILED AS OF DATE: 20231221 DATE AS OF CHANGE: 20231221 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Widdows Peter CENTRAL INDEX KEY: 0001997183 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41106 FILM NUMBER: 231506958 MAIL ADDRESS: STREET 1: 105 / 8 CENTURY CIRCUIT CITY: NORWEST, NSW STATE: C3 ZIP: 2153 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Incannex Healthcare Inc. CENTRAL INDEX KEY: 0001873875 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 000000000 STATE OF INCORPORATION: C3 FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 401 DOCKLANDS DRIVE STREET 2: SUITE 15, LEVEL 12 CITY: DOCKLANDS, VICTORIA STATE: C3 ZIP: 3008 BUSINESS PHONE: 61 409 840 786 MAIL ADDRESS: STREET 1: 401 DOCKLANDS DRIVE STREET 2: SUITE 15, LEVEL 12 CITY: DOCKLANDS, VICTORIA STATE: C3 ZIP: 3008 FORMER COMPANY: FORMER CONFORMED NAME: Incannex Healthcare Ltd DATE OF NAME CHANGE: 20210720 4 1 ownership.xml X0508 4 2023-12-21 0 0001873875 Incannex Healthcare Inc. IXHL 0001997183 Widdows Peter 105 / 8 CENTURY CIRCUIT NORWEST, NEW SOUTH WALES C3 2153 AUSTRALIA 1 0 0 0 0 Common Stock 2023-12-21 4 A 0 100000 0 A 270847 D Award of restricted stock of which 25,000 shares will vest on December 31, 2023, 25,000 shares concerning the remuneration of fiscal year 2023 will vest on June 30, 2024, 25,000 shares concerning the remuneration of fiscal year 2024 will vest on June 30, 2024, and 25,000 shares will vest on June 30, 2025, based upon the Reporting Person's continuing service as director on each vesting date. /s/ Peter Widdows 2023-12-21