0001493152-21-011586.txt : 20210514
0001493152-21-011586.hdr.sgml : 20210514
20210514194722
ACCESSION NUMBER: 0001493152-21-011586
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210512
FILED AS OF DATE: 20210514
DATE AS OF CHANGE: 20210514
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bluestone Jeffrey
CENTRAL INDEX KEY: 0001771814
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38552
FILM NUMBER: 21926940
MAIL ADDRESS:
STREET 1: C/O PROVENTION BIO, INC.
STREET 2: P.O. BOX 666
CITY: OLDWICK
STATE: NJ
ZIP: 08858
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Provention Bio, Inc.
CENTRAL INDEX KEY: 0001695357
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 55 BROAD STREET, 2ND FLOOR
CITY: RED BANK
STATE: NJ
ZIP: 07701
BUSINESS PHONE: 908-428-9136
MAIL ADDRESS:
STREET 1: 55 BROAD STREET, 2ND FLOOR
CITY: RED BANK
STATE: NJ
ZIP: 07701
FORMER COMPANY:
FORMER CONFORMED NAME: Provention Inc.
DATE OF NAME CHANGE: 20170120
4
1
ownership.xml
X0306
4
2021-05-12
0
0001695357
Provention Bio, Inc.
PRVB
0001771814
Bluestone Jeffrey
C/O PROVENTION BIO, INC.
55 BROAD STREET, 2ND FLOOR
RED BANK
NJ
07701
1
0
0
0
Stock Option (right to buy)
6.80
2021-05-12
4
A
0
23000
0
A
2031-05-12
Common Stock, par value $0.0001
23000
23000
D
The options will vest in full and become exercisable upon the earlier to occur of (a) the business day before the Issuer's next annual meeting of stockholders and (b) May 12, 2022.
The securities were granted pursuant to the Issuer's Amended and Restated 2017 Equity Incentive Plan.
/s/ Andrew Drechsler, as attorney-in-fact
2021-05-14