0001600132-17-000102.txt : 20170926 0001600132-17-000102.hdr.sgml : 20170926 20170926165912 ACCESSION NUMBER: 0001600132-17-000102 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170922 FILED AS OF DATE: 20170926 DATE AS OF CHANGE: 20170926 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tasse Daniel CENTRAL INDEX KEY: 0001502785 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36845 FILM NUMBER: 171102611 MAIL ADDRESS: STREET 1: C/O IKARIA, INC. STREET 2: 6 STATE ROUTE 173 CITY: CLINTON STATE: NJ ZIP: 08809 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Bellerophon Therapeutics, Inc. CENTRAL INDEX KEY: 0001600132 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 473116175 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 184 LIBERTY CORNER ROAD, SUITE 302 CITY: WARREN STATE: NJ ZIP: 07059 BUSINESS PHONE: 908-574-4770 MAIL ADDRESS: STREET 1: 184 LIBERTY CORNER ROAD, SUITE 302 CITY: WARREN STATE: NJ ZIP: 07059 FORMER COMPANY: FORMER CONFORMED NAME: Bellerophon Therapeutics LLC DATE OF NAME CHANGE: 20140213 4 1 wf-form4_150645953894625.xml FORM 4 X0306 4 2017-09-22 0 0001600132 Bellerophon Therapeutics, Inc. BLPH 0001502785 Tasse Daniel C/O BELLEROPHON THERAPEUTICS, INC. 184 LIBERTY CORNER ROAD, SUITE 302 WARREN NJ 07059 1 0 0 0 Stock Option (right to buy) 1.12 2017-09-22 4 A 0 10000 0 A 2027-09-21 Common Stock 10000.0 10000 D This option was granted on September 22, 2017. This option vests in three equal annual installments over a three-year period from the date of grant. /s/ Daniel Tasse 2017-09-26