0001683168-21-002744.txt : 20210628 0001683168-21-002744.hdr.sgml : 20210628 20210628165059 ACCESSION NUMBER: 0001683168-21-002744 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210624 FILED AS OF DATE: 20210628 DATE AS OF CHANGE: 20210628 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Matsuda Kazuko CENTRAL INDEX KEY: 0001531140 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33185 FILM NUMBER: 211054150 MAIL ADDRESS: STREET 1: C/O MEDICINOVA, INC. STREET 2: 4275 EXECUTIVE SQUARE, SUITE 650 CITY: LA JOLLA STATE: CA ZIP: 92037 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MEDICINOVA INC CENTRAL INDEX KEY: 0001226616 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 330927979 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4275 EXECUTIVE SQUARE STREET 2: SUITE 300 CITY: LA JOLLA STATE: CA ZIP: 92037 BUSINESS PHONE: 858-373-1500 MAIL ADDRESS: STREET 1: 4275 EXECUTIVE SQUARE STREET 2: SUITE 300 CITY: LA JOLLA STATE: CA ZIP: 92037 4 1 ownership.xml X0306 4 2021-06-24 0 0001226616 MEDICINOVA INC MNOV 0001531140 Matsuda Kazuko C/O MEDICINOVA, INC. 4275 EXECUTIVE SQUARE, SUITE 300 LA JOLLA CA 92037 1 1 0 0 Chief Medical Officer Common Stock 2021-06-24 4 M 0 46554 2.54 A 206746 D Common Stock 2021-06-24 4 M 0 56250 2.46 A 262996 D Employee Stock Option (Right to Buy) 2.54 2021-06-24 4 M 0 46554 0 D 2021-07-12 Common Stock 46554 0 D Employee Stock Option (Right to Buy) 2.46 2021-06-24 4 M 0 56250 0 D 2021-08-02 Common Stock 56250 0 D The option vested over a period of 4 years in equal monthly installments from the 7/13/2011 date of grant and is now fully vested. The option was granted on 8/3/2011, was subject to vesting based on achievement of performance criteria and vested in full on 6/14/2012. /s/ Yuichi Iwaki, attorney-in-fact 2021-06-28