0001144204-16-080886.txt : 20160211
0001144204-16-080886.hdr.sgml : 20160211
20160211162433
ACCESSION NUMBER: 0001144204-16-080886
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160209
FILED AS OF DATE: 20160211
DATE AS OF CHANGE: 20160211
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Alliqua BioMedical, Inc.
CENTRAL INDEX KEY: 0001054274
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 582349413
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2150 CABOT BOULEVARD WEST
CITY: LANGHORNE
STATE: PA
ZIP: 19047
BUSINESS PHONE: 215-702-8550
MAIL ADDRESS:
STREET 1: 2150 CABOT BOULEVARD WEST
CITY: LANGHORNE
STATE: PA
ZIP: 19047
FORMER COMPANY:
FORMER CONFORMED NAME: Alliqua, Inc.
DATE OF NAME CHANGE: 20101222
FORMER COMPANY:
FORMER CONFORMED NAME: HEPALIFE TECHNOLOGIES INC
DATE OF NAME CHANGE: 20030529
FORMER COMPANY:
FORMER CONFORMED NAME: ZETA CORP
DATE OF NAME CHANGE: 20030219
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Johnson David Ian
CENTRAL INDEX KEY: 0001563432
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36278
FILM NUMBER: 161411810
MAIL ADDRESS:
STREET 1: C/O ALLIQUA, INC.
STREET 2: 850 3RD AVENUE, 18TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
4
1
v431334_4.xml
OWNERSHIP DOCUMENT
X0306
4
2016-02-09
0
0001054274
Alliqua BioMedical, Inc.
ALQA
0001563432
Johnson David Ian
C/O ALLIQUA, INC.
2150 CABOT BLVD. WEST, SUITE B
LANGHORNE
PA
19047
1
1
0
0
President and CEO
Common Stock
2016-02-09
4
A
0
59932
0
A
644535
D
Represents a restricted stock award portion of Mr. Johnson's 2015 bonus amount based on the value of the Issuer's common stock on the date of grant. This award is subject to forfeiture until vested, with 100% vesting on February 9, 2017, subject to Mr. Johnson's continued service through the applicable vesting date and the terms and conditions of the Alliqua BioMedical, Inc. 2014 Long-Term Incentive Plan and that certain restricted stock award agreement by and between the Issuer and Mr. Johnson, effective as of February 9, 2016.
/s/ David I. Johnson
2016-02-11