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