0000914190-20-000176.txt : 20200518 0000914190-20-000176.hdr.sgml : 20200518 20200518162754 ACCESSION NUMBER: 0000914190-20-000176 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200514 FILED AS OF DATE: 20200518 DATE AS OF CHANGE: 20200518 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: 20889917 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 2020-05-14 0001603454 Celcuity Inc. CELC 0001296457 Dalvey David 16305 36TH AVENUE NORTH SUITE 100 MINNEAPOLIS MN 55446 1 0 0 0 Common Stock 2020-05-14 4 A 0 7843 0 A 7843 D 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 2029-05-16 Common Stock 5054 5054 D Stock Option (right to buy) 5.10 2020-05-14 4 A 0 12654 0 A 2030-05-14 Common Stock 12654 12654 D Represents 7,843 shares of restricted stock for which risks of forfeiture lapse on April 30, 2021, or if earlier, the date of the Company's 2021 Annual Meeting of Stockholders. 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, 2021, or if earlier, the date of the Company's 2021 Annual Meeting of Stockholders. /s/ Eric O. Madson as Attorney-in-Fact for David F. Dalvey pursuant to Power of Attorney previously filed. 2020-05-18