0001209191-22-013741.txt : 20220228 0001209191-22-013741.hdr.sgml : 20220228 20220228182904 ACCESSION NUMBER: 0001209191-22-013741 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220225 FILED AS OF DATE: 20220228 DATE AS OF CHANGE: 20220228 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TIDMARSH GEORGE F CENTRAL INDEX KEY: 0001287235 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39603 FILM NUMBER: 22692511 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: REVELATION BIOSCIENCES, INC. CENTRAL INDEX KEY: 0001810560 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 843898466 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4660 LAJOLLA VILLAGE DRIVE STREET 2: SUITE 100 CITY: SAN DIEGO STATE: CA ZIP: 92122 BUSINESS PHONE: 650-800-3717 MAIL ADDRESS: STREET 1: 4660 LAJOLLA VILLAGE DRIVE STREET 2: SUITE 100 CITY: SAN DIEGO STATE: CA ZIP: 92122 FORMER COMPANY: FORMER CONFORMED NAME: Petra Acquisition Inc. DATE OF NAME CHANGE: 20200423 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-02-25 0 0001810560 REVELATION BIOSCIENCES, INC. REVB 0001287235 TIDMARSH GEORGE F C/O REVELATION BIOSCIENCES, INC. 4660 LA JOLLA VILLAGE DR., SUITE 100 SAN DIEGO CA 92122 1 0 1 0 Common Stock 2022-02-25 4 P 0 20000 1.60 A 467156 D Common Stock 1523335 I By Trust Shares are held by George Tidmarsh, Trustee George Francis Tidmarsh 2021 Irrevocable Trust with respect to which George Tidmarsh is a trustee. /s/ J.P. Galda, as attorney-in-fact for George F Tidmarsh 2022-02-28