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