0001354488-12-000796.txt : 20120221
0001354488-12-000796.hdr.sgml : 20120220
20120221173007
ACCESSION NUMBER: 0001354488-12-000796
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120216
FILED AS OF DATE: 20120221
DATE AS OF CHANGE: 20120221
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sklar Jeffrey
CENTRAL INDEX KEY: 0001509170
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-29819
FILM NUMBER: 12627860
MAIL ADDRESS:
STREET 1: 500 BEDFORD AVENUE
CITY: BELLMORE
STATE: NY
ZIP: 11710
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Alliqua, Inc.
CENTRAL INDEX KEY: 0001054274
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 582349413
STATE OF INCORPORATION: FL
FISCAL YEAR END: 1220
BUSINESS ADDRESS:
STREET 1: 850 THIRD AVENUE
STREET 2: SUITE 1801
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 800-518-4879
MAIL ADDRESS:
STREET 1: 850 THIRD AVENUE
STREET 2: SUITE 1801
CITY: NEW YORK
STATE: NY
ZIP: 10022
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
FORMER COMPANY:
FORMER CONFORMED NAME: ZETA CORP /CA
DATE OF NAME CHANGE: 20000303
4
1
issuerdirect_section16.xml
PRIMARY DOCUMENT
X0304
4
2012-02-16
0
0001054274
Alliqua, Inc.
ALQA.OB
0001509170
Sklar Jeffrey
850 THIRD AVENUE
SUITE 1801
NEW YORK
NY
10022
1
Common Stock
2012-02-16
4
P
0
1000000
A
1280000
D
Common Stock Warrants (right to buy)
0.069
2012-02-16
4
P
0
500000
A
2012-02-16
2017-02-16
Common Stock
500000
1780000
D
Mr. Sklar purchased, as part of a private placement transaction on February 16, 2012, 1,000,000 units at a price per unit of $0.05, with each unit consisting of 1 share of common stock and a warrant to purchase 0.5 of a share of common stock.
See Footnote
/s/ Jeffrey Sklar
2012-02-21