0001140361-21-013551.txt : 20210420
0001140361-21-013551.hdr.sgml : 20210420
20210420201602
ACCESSION NUMBER: 0001140361-21-013551
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210416
FILED AS OF DATE: 20210420
DATE AS OF CHANGE: 20210420
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Federoff Howard J.
CENTRAL INDEX KEY: 0001857261
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-11460
FILM NUMBER: 21839230
MAIL ADDRESS:
STREET 1: C/O BROOKLYN IMMUNOTHERAPEUTICS, INC.
STREET 2: 140 58TH STREET, BUILDING A, SUITE 2100
CITY: BROOKLYN
STATE: NY
ZIP: 11220
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Brooklyn ImmunoTherapeutics, Inc.
CENTRAL INDEX KEY: 0000748592
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 311103425
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 140 58TH STREET, BUILDING A
STREET 2: SUITE 2100
CITY: BROOKLYN
STATE: NY
ZIP: 11220
BUSINESS PHONE: (212) 582-1199
MAIL ADDRESS:
STREET 1: 140 58TH STREET, BUILDING A
STREET 2: SUITE 2100
CITY: BROOKLYN
STATE: NY
ZIP: 11220
FORMER COMPANY:
FORMER CONFORMED NAME: NTN BUZZTIME INC
DATE OF NAME CHANGE: 20051230
FORMER COMPANY:
FORMER CONFORMED NAME: NTN COMMUNICATIONS INC
DATE OF NAME CHANGE: 19920703
FORMER COMPANY:
FORMER CONFORMED NAME: ALROY INDUSTRIES INC
DATE OF NAME CHANGE: 19850411
4
1
form4.xml
FORM 4
X0306
4
2021-04-16
0000748592
Brooklyn ImmunoTherapeutics, Inc.
BTX
0001857261
Federoff Howard J.
C/O BROOKLYN IMMUNOTHERAPEUTICS, INC.
140 58TH STREET, BUILDING A, SUITE 2100
BROOKLYN
NY
11220
true
true
See Remarks
Stock Option
7.94
2021-04-16
4
A
0
2627915
0
A
2031-04-15
Common Stock
2627915
2627915
D
Stock Option
7.94
2021-04-16
4
A
0
597253
0
A
2031-04-15
Common Stock
597253
597253
D
The option vests and becomes exercisable over four years, with 656,979 shares vesting on April 16, 2022, 54,748 shares vesting on the sixteenth day of each month from May 2022 through March 2025, and the remaining 54,756 shares vesting on April 16, 2025, subject to continued service through each vesting date.
The option vests and becomes exercisable in full upon the occurrence of the first approval by the Food and Drug Administration of an investigational new drug application in connection with that certain license among the Issuer, Factor Biosciences Therapeutics Limited and Novellus Therapeutics Limited, subject to continued service through such vesting date.
Chief Executive Officer and President
/s/ Mark L. Johnson, Attorney-in-Fact for Howard J. Federoff
2021-04-20