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