0001600132-17-000113.txt : 20171003 0001600132-17-000113.hdr.sgml : 20171003 20171003160716 ACCESSION NUMBER: 0001600132-17-000113 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170929 FILED AS OF DATE: 20171003 DATE AS OF CHANGE: 20171003 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Amin Naseem CENTRAL INDEX KEY: 0001646754 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36845 FILM NUMBER: 171117857 MAIL ADDRESS: STREET 1: 53 FRONTAGE ROAD, SUITE 301 CITY: HAMPTON STATE: NJ ZIP: 08827 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_150706122333359.xml FORM 4 X0306 4 2017-09-29 0 0001600132 Bellerophon Therapeutics, Inc. BLPH 0001646754 Amin Naseem C/O BELLEROPHON THERAPEUTICS, INC. 184 LIBERTY CORNER ROAD, SUITE 302 WARREN NJ 07059 1 0 0 0 Common Stock 2017-09-29 4 P 0 456432 A 1230314 D Common Stock Warrants (right to buy) 1.242 2017-09-29 4 P 0 456432 A 2018-03-29 2022-09-29 Common Stock 456432.0 456432 D The reported securities are included within Units purchased by the reporting person for $1.205 per Unit. Each Unit consists of one share of common stock and one warrant to purchase one share of common stock. /s/ Naseem Amin 2017-10-03