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