0001493152-21-018719.txt : 20210805
0001493152-21-018719.hdr.sgml : 20210805
20210805160702
ACCESSION NUMBER: 0001493152-21-018719
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210803
FILED AS OF DATE: 20210805
DATE AS OF CHANGE: 20210805
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: King-Jones Heidy
CENTRAL INDEX KEY: 0001794898
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38552
FILM NUMBER: 211148161
MAIL ADDRESS:
STREET 1: C/O AXCELLA HEALTH INC.
STREET 2: 840 MEMORIAL DRIVE
CITY: CAMBRIDGE
STATE: MA
ZIP: 02139
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
2021-08-03
0
0001695357
Provention Bio, Inc.
PRVB
0001794898
King-Jones Heidy
C/O PROVENTION BIO, INC.
55 BROAD STREET, 2ND FLOOR
RED BANK
NJ
07701
0
1
0
0
Chief Legal Officer
Stock Option (right to buy)
11.23
2021-08-03
4
A
0
30000
0
A
2021-08-03
2030-08-03
Common Stock, par value $0.0001
30000
150000
D
As previously reported on a Form 4 filed on August 3, 2020, on August 3, 2020 the Reporting Person was granted a stock option for 300,000 shares of Common Stock, 120,000 of which option shares vest in four equal annual installments commencing on August 3, 2021 and 180,000 of which option shares vest upon completion of certain performance milestones. This amount represents the vesting of 30,000 of the 180,000 performance option shares on August 3, 2021 upon the satisfaction of certain performance milestones. This Form 4 is being filed solely to report the vesting of such previously reported 30,000 option shares.
The stock options were granted pursuant to the Issuer's Amended and Restated 2017 Equity Incentive Plan.
Represents the 120,000 time-based option shares referred to in footnote (1) plus the 30,000 vested performance option shares referred to in footnote (1). Excludes 150,000 of the previously reported 300,000 option shares referred to in footnote (1) that are performance option shares that remain subject to vesting upon completion of certain performance milestones.
/s/ Andrew Drechsler, as attorney-in-fact
2021-08-05