0001213900-21-056464.txt : 20211103 0001213900-21-056464.hdr.sgml : 20211103 20211103163418 ACCESSION NUMBER: 0001213900-21-056464 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211102 FILED AS OF DATE: 20211103 DATE AS OF CHANGE: 20211103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Claiborne Cary J CENTRAL INDEX KEY: 0001370930 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38323 FILM NUMBER: 211376006 MAIL ADDRESS: STREET 1: 3056 SENECA CHIEF TRAIL CITY: ELLICOTT CITY STATE: MD ZIP: 21042 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ADIAL PHARMACEUTICALS, INC. CENTRAL INDEX KEY: 0001513525 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 800667150 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1180 SEMINOLE TRAIL STREET 2: SUITE 495 CITY: CHARLOTTESVILLE STATE: VA ZIP: 22901 BUSINESS PHONE: 434-422-9800 MAIL ADDRESS: STREET 1: 1180 SEMINOLE TRAIL STREET 2: SUITE 495 CITY: CHARLOTTESVILLE STATE: VA ZIP: 22901 FORMER COMPANY: FORMER CONFORMED NAME: ADial Pharmaceuticals, L.L.C. DATE OF NAME CHANGE: 20170515 FORMER COMPANY: FORMER CONFORMED NAME: Adial Pharmaceuticals, L.L.C. DATE OF NAME CHANGE: 20110218 3 1 ownership.xml OWNERSHIP DOCUMENT X0206 3 2021-11-02 1 0001513525 ADIAL PHARMACEUTICALS, INC. ADIL 0001370930 Claiborne Cary J 1180 SEMINOLE TRAIL, SUITE 495 CHARLOTTESVILLE, VA 22902 1 0 0 0 /s/ Cary J. Claiborne 2021-11-03