0001144204-17-053031.txt : 20171018 0001144204-17-053031.hdr.sgml : 20171018 20171018161729 ACCESSION NUMBER: 0001144204-17-053031 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171017 FILED AS OF DATE: 20171018 DATE AS OF CHANGE: 20171018 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BAUER EUGENE A CENTRAL INDEX KEY: 0001210524 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35112 FILM NUMBER: 171142781 MAIL ADDRESS: STREET 1: C/O DERMIRA, INC. STREET 2: 275 MIDDLEFIELD ROAD, SUITE 150 CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Aevi Genomic Medicine, Inc. CENTRAL INDEX KEY: 0001138776 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 980217544 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 435 DEVON PARK DRIVE, STREET 2: SUITE 715 CITY: WAYNE STATE: PA ZIP: 19087 BUSINESS PHONE: 610-254-4201 MAIL ADDRESS: STREET 1: 435 DEVON PARK DRIVE, STREET 2: SUITE 715 CITY: WAYNE STATE: PA ZIP: 19087 FORMER COMPANY: FORMER CONFORMED NAME: MEDGENICS, INC. DATE OF NAME CHANGE: 20090623 FORMER COMPANY: FORMER CONFORMED NAME: MEDGENICS INC DATE OF NAME CHANGE: 20010419 4 1 tv477170_4.xml OWNERSHIP DOCUMENT X0306 4 2017-10-17 0 0001138776 Aevi Genomic Medicine, Inc. GNMX 0001210524 BAUER EUGENE A C/O AEVI GENOMIC MEDICINE, INC. 435 DEVON PARK DRIVE, SUITE 715 WAYNE PA 19087 1 0 0 0 Common Stock 2017-10-17 4 P 0 19841 1.26 A 165715 D Warrant (right to buy) 2.84 2017-10-17 4 P 0 3530 0 A 2017-10-17 2022-10-17 Common Stock 3530 3530 D /s/ Brian Piper as Attorney-In-Fact For Eugene A. Bauer 2017-10-18