0001683168-21-003082.txt : 20210723
0001683168-21-003082.hdr.sgml : 20210723
20210723162748
ACCESSION NUMBER: 0001683168-21-003082
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210709
FILED AS OF DATE: 20210723
DATE AS OF CHANGE: 20210723
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: IWAKI YUICHI
CENTRAL INDEX KEY: 0001263965
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33185
FILM NUMBER: 211111173
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
2021-07-09
0
0001226616
MEDICINOVA INC
MNOV
0001263965
IWAKI YUICHI
C/O MEDICINOVA, INC.
4275 EXECUTIVE SQUARE, SUITE 300
LA JOLLA
CA
92037
1
1
0
0
President and CEO
Common Stock
2021-07-09
4
M
0
39583
2.54
A
966933
D
Common Stock
125000
I
See Footnote
Employee Stock option (Right to Buy)
2.54
2021-07-09
4
M
0
39583
0
D
2021-07-12
Common Stock
39583
0
D
The reported securities are held by the Iwaki Family Limited Partnership. The reporting person is the general partner of the partnership that owns the reported securities. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
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.
/s/ Yuichi Iwaki
2021-07-23