0001493152-18-018148.txt : 20181231
0001493152-18-018148.hdr.sgml : 20181231
20181231180043
ACCESSION NUMBER: 0001493152-18-018148
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181228
FILED AS OF DATE: 20181231
DATE AS OF CHANGE: 20181231
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Palmer Ashleigh
CENTRAL INDEX KEY: 0001493714
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38552
FILM NUMBER: 181260429
MAIL ADDRESS:
STREET 1: PROVENTION BIO, INC.
STREET 2: 110 OLD DRIFTWAY LANE
CITY: LEBANON
STATE: NJ
ZIP: 08833
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Provention Bio, Inc.
CENTRAL INDEX KEY: 0001695357
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: P.O. BOX 666
CITY: OLDWICK
STATE: NJ
ZIP: 08858
BUSINESS PHONE: 908-428-9136
MAIL ADDRESS:
STREET 1: P.O. BOX 666
CITY: OLDWICK
STATE: NJ
ZIP: 08858
FORMER COMPANY:
FORMER CONFORMED NAME: Provention Inc.
DATE OF NAME CHANGE: 20170120
4
1
ownership.xml
X0306
4
2018-12-28
0
0001695357
Provention Bio, Inc.
PRVB
0001493714
Palmer Ashleigh
C/O PROVENTION BIO, INC.
P.O. BOX 666
OLDWICK
NJ
08858
1
1
0
0
President and CEO
Common Stock
2018-12-28
4
P
0
5000
1.73
A
2542500
D
Common Stock
2018-12-31
4
P
0
825
1.58
A
2543325
D
/s/ Andrew Drechsler, as attorney-in-fact
2018-12-31