0001209191-23-053102.txt : 20231018 0001209191-23-053102.hdr.sgml : 20231018 20231018171545 ACCESSION NUMBER: 0001209191-23-053102 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231016 FILED AS OF DATE: 20231018 DATE AS OF CHANGE: 20231018 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: 231332839 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 X0508 4 2023-10-16 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 0 0 0 Common Stock 2023-10-16 4 S 0 1845 0.6501 D 27771 D Common Stock 42096 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 2023-10-18