0001213900-23-043111.txt : 20230525 0001213900-23-043111.hdr.sgml : 20230525 20230525163603 ACCESSION NUMBER: 0001213900-23-043111 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230523 FILED AS OF DATE: 20230525 DATE AS OF CHANGE: 20230525 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Claiborne Cary J CENTRAL INDEX KEY: 0001370930 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38323 FILM NUMBER: 23961359 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 4 1 ownership.xml X0407 4 2023-05-23 0 0001513525 ADIAL PHARMACEUTICALS, INC. ADIL 0001370930 Claiborne Cary J 1180 SEMINOLE TRAIL, SUITE 495 CHARLOTTESVILLE, VA 22901 1 1 0 0 Chief Executive Officer 0 Common Stock 2023-05-23 4 A 0 420000 0 A 1520000 D Stock Option (Right to Buy) 0.3025 2023-05-23 4 A 0 300000 0 A 2023-05-23 2033-05-23 Common Stock 300000 300000 D The option vests pro rata on a monthly basis over 36 months commencing May 23, 2023. /s/ Cary J. Claiborne 2023-05-25