0000914190-19-000178.txt : 20190520 0000914190-19-000178.hdr.sgml : 20190520 20190520160434 ACCESSION NUMBER: 0000914190-19-000178 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190516 FILED AS OF DATE: 20190520 DATE AS OF CHANGE: 20190520 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dalvey David CENTRAL INDEX KEY: 0001296457 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38207 FILM NUMBER: 19838716 MAIL ADDRESS: STREET 1: C/O BLUE ROCK ADVISORS, INC. STREET 2: 80 SOUTH EIGHTH STREET SUITE 3915 CITY: MINNEAPOLIS STATE: MN ZIP: 55402 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Celcuity Inc. CENTRAL INDEX KEY: 0001603454 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 16305 36TH AVENUE N STREET 2: SUITE 100 CITY: MINNEAPOLIS STATE: MN ZIP: 55446 BUSINESS PHONE: 763-392-0767 MAIL ADDRESS: STREET 1: 16305 36TH AVENUE N STREET 2: SUITE 100 CITY: MINNEAPOLIS STATE: MN ZIP: 55446 FORMER COMPANY: FORMER CONFORMED NAME: Celcuity LLC DATE OF NAME CHANGE: 20140324 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2019-05-16 0001603454 Celcuity Inc. CELC 0001296457 Dalvey David 16305 36TH AVENUE NORTH MINNEAPOLIS MN 55446 1 0 0 0 Common Stock 250000 I By Brightstone Venture Capital Fund, LP Stock Option (right to buy) 16.23 2027-10-19 Common Stock 8200 8200 D Stock Option (right to buy) 19.45 2028-05-14 Common Stock 3201 3201 D Stock Option (right to buy) 22.45 2019-05-16 4 A 0 5054 0 A 2029-05-16 Common Stock 5054 5054 D The Reporting Person is the General Partner of Brightstone Venture Capital Fund, LP. 100% vested. This Option will vest and become exercisable on April 30, 2020, or if earlier, the date of the Company's 2020 Annual Meeting of Stockholders. /s/ Eric O. Madson as Attorney-in-Fact for David F. Dalvey pursuant to Power of Attorney previously filed. 2019-05-20